Common Codes for Billing: Contraceptive Management Visits
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Common Codes for Billing: Contraceptive Management For dates of service POST to October 1, 2015: Use Visits ICD-10 CM Codes Procedure / Supply Method Codes ICD-10 Description Oral Z30.011 Initiate OC E/M /S4993 Contraceptives Z30.41 Surveillance of OC (Includes refills) Z30.13 Initial prescription of injectable contraceptive E/M / injection Depo Provera / J1050 Z30.42 Surveillance of injectable contraceptive Emergency E/M / check with payer Z30.012 Encounter for prescription of EC Contraception for code Z30.018 Initial prescription of other contraceptives Hormonal Patch E/M / J7304 Z30.49 Encounter for surveillance of other contraceptives Natural Family Counseling and instruction in natural family planning to E/M Z30.02 Planning avoid pregnancy Z30.018 Initial prescription of other contraceptives E/M / Vaginal Ring J7303 Z30.49 Encounter for surveillance of other contraceptives No method Encounter for other general counseling and advice on con- E/M Z30.09 dispensed traception LARC’s (Long Acting Reversible Contraception) Encounter for initial prescription of IUD (not coded with IUD E/M Z30.014 insertion) 58300/J7300, J7301,J7297, Z30.430 Encounter for Insertion of IUD J7298 IUD 58300,58301/ J7300, J7301, Z30.433 Encounter for Removal and Re-insertion of IUD J7297, J7298 E/M Z30.431 Encounter for routine checking of IUD 58301 Z30.432 Encounter for Removal of IUD E/M Z97.5 Presence of IUD 11981 / J7307 Z30.018 I Initial prescription of other contraceptives 11982 Implant Encounter for surveillance of other contraceptives (includes E/M Z30.49 surveillance, removal and re-insertion of Implant) 11983 / J7307 E/M Z97.5 Presence of Implant FREQUENTLY USED CODES Commonly Used ICD-10 Codes in Reproductive Healthcare Female Reproductive Healthcare Breast Conditions Infertility Uterus N60.(01/02) Solitary cyst of breast (R/L) N97.0 Infertility-anovulation C54.1 Cancer of endometrium N60.(11/12) Fibrocystic change (R/L) E23.0 Hypopituarism C54.2 Cancer of myometrium N61 Mastitis, NOS N97.1 Infertility-tubal origin C54.3 Cancer of fundus uteri N64.0 Fissure and fistula of nipple N97.2 Infertility-uterine origin C54.9 Cancer of corpus uteri, unspec. N64.3 Galactorrhea N97.8 Infertility-cervical origin D25.9 Uterine myoma N64.4 Mastodynia N97.9 Female infertility, NOS N84.0 Polyp of corpus uteri N63 Lump or mass in breast N84.8 Polyp of other parts of fem genital N64.51 Induration of breast Menopause N84.9 Polyptract of fem. genital tract, unspec. N64.53 Retraction of nipple N92.4 Perimenopausal menorrhagia N85.00 Endometrial hyperplasia N64.59 Other signs/ symptoms in breast N95.0 Postmenopausal bleeding N85.4 Malposition of uterus N64.53 Retraction of nipple N95.1 Menopausal syndrome N85.6 Asherman’s syndrome O91.23 Mastitis, postpartum, unspec. N95.2 Atrophic vaginitis N85.7 Hematometra R92.8 Abnormal mammogram N95.8 Symptoms w artificial menopause N85.9 Disorder of uterus, NOS N95.9 Menopausal disorder NOS Cervix Urinary Tract C53.0 Endocervical cancer Ovary and Adnexa N30. 10 Interstitial cystitis w/o hematuria C53.1 Exocervical cancer C56.1 Malignant neoplasm of right ovary N30.11 Interstitial cystitis w/ hematuria C53.9 Cervical cancer, NOS C56.2 Malignant neoplasm of left ovary N34.3 Urethral syndrome D06.0 CIN 3 biopsy endocervix N83.0 Follicular cyst of ovary N39.3 Stress incontinence D06.1 CIN 3 exocervix N83.1 Corpus luteum cyst N39.41 Urge incontinence D06.7 CIN 3, other parts of cervix N83.20 Unspecified ovarian cysts N39.46 Mixed incontinence D06.8 CIN 3, cervix, unspecified N83.29 Other ovarian cysts R30.0 Dysuria N86 Erosion/ectropion cervix N83.51 Torsion of ovary and ovarian R32 Urinary incontinence, unspecified N87.9 Dysplasia, NOS N83.52 Torsionpedicle of fallopian tube R35.0 Urinary frequency N87.0 CIN 1 biopsy N83.53 Torsion of ovary, ovarian pedicle R35.8 Other polyuria N87.1 CIN 2 biopsy and fallopian tube R39.11 Urinary hesitancy N88,1 Leukoplakia N83.9 Noninflammatory disorder of R39.14 Incomplete bladder emptying N88.2 Stricture/stenosis of cervix ovary, fallopian tube and broad R39.15 Urinary urgency N84.1 Cervical polyp ligament, unspecified R39.16 Straining on urination R87.619 AGC cytology R87.610 ASC-US cytology Pain Syndromes Vagina R87.611 ASC-H cytology G43.001 Migraine, without aura N89.0 Mild vaginal dysplasia R87.612 LSIL cytology G43.101 Migraine, with aura N89.1 Moderate vaginal dysplasia R87.613 HSIL cytology G43.829 Migraine menstrual,not intractable N89.3 Dysplasia of vagina, unspecified R87.810 High risk HPV-DNA positive G43.909 Migraine, unspecified N89.6 Tight hymenal ring R87.614 Cytologic evidence of malignancy G44.209 Headache, tension N89.8 Other specified noninflammatory R87.616 Lacking transformation zone G44.(221/229) Headache, chronic tension-type N89.9 Noninflammatorydisorders of vagina disorder, NOS R87.615 Unsatisfactory cytology (intractable/ not intractable) Vulva Endometriosis M60.8-851 Myofascial pain N94. (4/5/6) Dysmenorrhea C51.9 Vulvar neoplasm, malignant N80.0 Endometriosis of uterus D07.1 VIN 3 N80.3 Endometriosis of pelvic N94.0 Mittelschmerz(primary/secondary/unspec.) N94.1 Dyspareunia D28.0 Vulvar neoplasm, benign N80.6 peritoneumEndometriosis in cutaneous scar N94.2 Vaginismus L28.0 Lichen simplex chronicus N80.9 Endometriosis, unspecified L28.1 Prurigo nodularis N94.810 Vulvar vestibulitis N94.819 Vulvodynia, NOS L90.0 Lichen sclerosus et atrophicus Gynecological Endocrine R10.10 Upper abdominal pain, unspecified L94.0 Localized scleroderma [morphea] L68.0 Hirsuitism L94.1 Linear scleroderma L68.1 Acquired hypertrichosis R10.2 Pelvic and perineal pain L94.3 Sclerodactyly L68.2 lanuginosaLocalized hypertrichosis R10.2 Pelvic and perineal pain N84.3 Polyp of vulva E28.310 Premature menopause R10.30 Lower abdominal pain, unspecified N90.0 VIN I E28.319 (symptoms)Premature menopause R10.32 Abdominal pain, LLQ N90.1 VIN 2 L68.3 (Polytrichia R10.33 Abdominal pain, RLQ N90.89 Other specified noninflammatory L68.8 Other hypertrichosis N90.9 Noninflamdisorders disof vulvavulva, and NOS perineum 256.4 PCOS R51 Headache, unspecified E66.8 Other obesity E28.2 Obesity, morbid E66.3 Overweight F50.9 noEating sympt Disorder,oms) unspecified Page 1 FREQUENTLY USED CODES Commonly Used ICD-10 Codes in Reproductive Healthcare (cont’d) Male Reproductive Healthcare Male Reproductive Healthcare (cont’d) A63.0 Penile lesion N52.03 Combined arterial insufficiency and E29.1 Testicular hypofunction corporo-venous occlusive ED F52.0 Hypoactive sexual desire disorder N52.1 ED due to diseases classified F52.21 Male erectile disorder elsewhere F52.4 Premature ejaculation N52.2 Drug-induced ED F52.8 Other sexual dysfunction, not N52.31 ED following radical prostatectomy related to substance use N52.32 ED following radical cystectomy /psychological cond. N52.33 ED following urethral surgery I86.1 Scrotal varices N52.34 ED following simple prostatectomy K62.7 Radiation proctitis N52.39 Other post-surgical ED K62.89 Other specified diseases of anus N62 Gynecomastia and rectum R10.2 Pelvic and perineal pain K62.9 Disease of anus and rectum, NOS R21 Rash, non-specific skin eruption R36.0 Urethral discharge w/o blood L23.9 Allergic contact dermatitis, R36.1 Hematospermia unspecified cause L24.9 Irritant contact dermatitis, R36.9 Urethral discharge unspecified L25.9 unspecifiedUnspecified causecontact dermatitis, unspecified cause L30.0 Nummular dermatitis Counseling L30.2 Cutaneous autosensitization F17.(200-291) Tobacco Abuse L30.8 Other specified dermatitis F32.9 Depressive disorder, single episode L30.9 Dermatitis, unspecified F33.9 Depressive disorder, recurrent L66.3 Perifolliculitis capitis abscedens F41.1 Anxiety, generalized L73.1 Pseudofolliculitis barbae F50.9 Eating disorder, unspecified L73.8 Other specified follicular disorders R68.82 Decreased libido N34.1 Nonspecific urethritis (NGU) Z60.(0-9) Problems related to social N34.1 Non-specific urethritis environment N34.2 Other Urethritis Z71.(41-60) Counseling on substance N39.3 Stress incontinence use/abuse N39.43 Post-void dribbling Z71.3 Dietary surveillance and counseling N40.0 Enlarged prostate without lower Z71.7 Human Immunodeficiency virus urinary tract symptoms (HIV) counseling N40.1 Enlarged prostate with lower Z71.89 Other specified counseling urinary tract symptoms Z71.9 Counseling NOS N41.0 Prostatitis, acute N41.1 Prostatitis, chronic Complications N41.9 Prostatitis, NOS K68.11 Postprocedural retroperitoneal N43.(40/41/42) Spermatocele R55 abscessSyncope (vasovagal) unspec/single/multiple T50.99 Drug allergy or hypersensitivity N43.3 Hydrocele 5AT81.4x Infection following a procedure N44.00 Torsion of testis, unspecified xAT83.31 Mechanical breakdown of IUD N45.1 Epididymitis xAT83.32 Displacement of IUD N45.2 Orchitis xAT83.39 Other mechanical complication of N45.3 Epididymo-orchitis xAT83.49 IUDMechanical complication of implant N46.9 Infertility, male 8AT83.59 Infection due to IUD/implant in N47.0 Adherent prepuce, newborn xAT83.6x urinaryInfection tract due to IUD/implant in N47.1 Phimosis xA genital tract N47.2 Paraphimosis Other Signs and Symptoms N47.3 Deficient foreskin G93.3 Postviral fatigue syndrome N47.4 Benign cyst of prepuce R11.0 Nausea, alone N47.5 Adhesions of prepuce and glans R11.10 Vomiting, unspecified N47.6 Balanoposthitispenis R11.11 Vomiting without nausea N47.7 Other inflammatory diseases of R11.12 Projectile vomiting N47.8 prepuceOther disorders of prepuce R11.2 Nausea with vomiting N48.(30-39) Priapisms R50.2 Drug induced fever N48.1 Balanitis R50.2 Drug induced fever N48.9 Disorder of penis, unspecified