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monthly pregnancy test due to acne treatment

  1. #1
    Default monthly pregnancy test due to acne treatment
    Medical Coding Books
    we have a few patients who are on acne medications that can cause birth defects so our providers are requiring they return to our office monthly for a pregnancy test. the patients dont see a provider but they do see the nurse. i'm trying to see how others are billing for this situation - are you billing a nurse visit or do you just bill for the test?
    Dawnelle Beall, CPC, CPMA, CPC-I
    Licensed AAPC PMCC Instructor
    AAPC ICD-10CM Certified Trainer
    Previous AAPC Local Chapter President & VP

  2. #2
    Location
    Columbia, MO
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    since it is a scheduled test for which there is a code you do not code a 99211. you use the V72.4x for the dx code ans the appropriate test code.

    Debra A. Mitchell, MSPH, CPC-H

  3. #3
    Default
    Good point!
    Dawnelle Beall, CPC, CPMA, CPC-I
    Licensed AAPC PMCC Instructor
    AAPC ICD-10CM Certified Trainer
    Previous AAPC Local Chapter President & VP

  4. #4
    Default
    For our accutane patients we bill 81025 for the pregnancy test, with 706.1 and V58.69 diagnoses. This is accepted from every major payer.

    Jen Verlinda, CPC

  5. Default
    Your code sets seem to be incomplete.
    V 58.69 is code for long term drug usage and 706.1 is for dermatological condition.
    don't you think that we have to report that there was a preg test ordered which is the main encounter every month before continuation of treatment for acne.
    As Mitchelle said the specific code for pergnancy test is the main Vcode.
    V 58.69 is not primary listed, either.
    Moreover your CPT code has to be supported by a pregnancy diagnosis code.
    Thanks

  6. #6
    Default
    The V58.69 is the secondary dx listed on this. The reason for the pregnancy test is due to the use of the medication, or "medication monitoring". We bill out our Accutane patients like such:

    99214-25-- A major ROS is done as a result of the Accutane tx.
    81025

    Dx: 706.1, V58.69

    This seems to be all encompassing and works for every major payor.

    Thanks for your feedback.

    Jen Verlinda, CPC

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