Common Codes for Billing: Contraceptive Management …

1 Common Codes for billing : Contraceptive Management VisitsFor dates of service POST to October 1, 2015: Use ICD-10 CM CodesMethodProcedure / Supply CodesICD-10 DescriptionOral Contraceptives E/M /S4993 of OC (Includes refills)Depo ProveraE/M / injection / J1050 prescription of injectable Contraceptive of injectable Contraceptive Emergency ContraceptionE/M / check with payer for for prescription of ECHormonal PatchE/M / J7304 prescription of other contraceptives for surveillance of other contraceptivesNatural Family and instruction in natural family planning to avoid pregnancyVaginal RingE/M / J7303 prescription of other contraceptives for surveillance of other contraceptivesNo method dispensedE/M for other general counseling and advice on con-traceptionLARC s (Long Acting Reversible Contraception) for initial prescription of IUD (not coded with IUD insertion)58300/J7300, J7301,J7297, for Insertion of IUD58300,58301/ J7300, J7301,J7297, for Removal and Re-insertion of for routine checking of for Removal of of IUDI mplant11981 / Initial prescription of other contraceptives11982 for surveillance of other contraceptives (includes surveillance, removal and re-insertion of Implant)E/M11983 / J7307 of Implant Page 1 FREQUENTLY USED Codes Commonly Used ICD-10 Codes in Reproductive Healthcare Female Reproductive Healthcare Breast Conditions N60.

2 (01/02) Solitary cyst of breast (R/L) N60.(11/12) Fibrocystic change (R/L) N61 Mastitis, NOS Fissure and fistula of nipple Galactorrhea Mastodynia N63 Lump or mass in breast Induration of breast Retraction of nipple Other signs/ symptoms in breast Retraction of nipple Mastitis, postpartum, unspec. Abnormal mammogram Cervix Endocervical cancer Exocervical cancer Cervical cancer, NOS CIN 3 biopsy endocervix CIN 3 exocervix CIN 3, other parts of cervix CIN 3, cervix, unspecified N86 Erosion/ectropion cervix Dysplasia, NOS CIN 1 biopsy CIN 2 biopsy N88,1 Leukoplakia Stricture/stenosis of cervix Cervical polyp AGC cytology ASC-US cytology ASC-H cytology LSIL cytology HSIL cytology High risk HPV-DNA positive Cytologic evidence of malignancy Lacking transformation zone Unsatisfactory cytology Endometriosis Endometriosis of uterus Endometriosis of pelvic peritoneum Endometriosis in cutaneous scar Endometriosis, unspecified Gynecological Endocrine Hirsuitism Acquired hypertrichosis lanuginosa Localized hypertrichosis Premature menopause (symptoms) Premature menopause (no symptoms)

3 Polytrichia Other hypertrichosis PCOS Other obesity Obesity, morbid Overweight Eating Disorder, unspecified Infertility Infertility-anovulation Hypopituarism Infertility-tubal origin Infertility-uterine origin Infertility-cervical origin Female infertility, NOS Menopause Perimenopausal menorrhagia Postmenopausal bleeding Menopausal syndrome Atrophic vaginitis Symptoms w artificial menopause Menopausal disorder NOS Ovary and Adnexa Malignant neoplasm of right ovary Malignant neoplasm of left ovary Follicular cyst of ovary Corpus luteum cyst Unspecified ovarian cysts Other ovarian cysts Torsion of ovary and ovarian pedicle Torsion of fallopian tube Torsion of ovary, ovarian pedicle and fallopian tube Noninflammatory disorder of ovary, fallopian tube and broad ligament, unspecified Pain Syndromes Migraine, without aura Migraine, with aura Migraine menstrual,not intractable Migraine, unspecified Headache, tension G44.

4 (221/229) Headache, chronic tension-type (intractable/ not intractable) Myofascial pain N94. (4/5/6) Dysmenorrhea (primary/secondary/unspec.) Mittelschmerz Dyspareunia Vaginismus Vulvar vestibulitis Vulvodynia, NOS Upper abdominal pain, unspecified Pelvic and perineal pain Pelvic and perineal pain Lower abdominal pain, unspecified Abdominal pain, LLQ Abdominal pain, RLQ R51 Headache, unspecified Uterus Cancer of endometrium Cancer of myometrium Cancer of fundus uteri Cancer of corpus uteri, unspec. Uterine myoma Polyp of corpus uteri Polyp of other parts of fem genital tract Polyp of fem. genital tract, unspec. Endometrial hyperplasia Malposition of uterus Asherman s syndrome Hematometra Disorder of uterus, NOS Urinary Tract N30. 10 Interstitial cystitis w/o hematuria Interstitial cystitis w/ hematuria Urethral syndrome Stress incontinence Urge incontinence Mixed incontinence Dysuria R32 Urinary incontinence, unspecified Urinary frequency Other polyuria Urinary hesitancy Incomplete bladder emptying Urinary urgency Straining on urination Vagina Mild vaginal dysplasia Moderate vaginal dysplasia Dysplasia of vagina, unspecified Tight hymenal ring Other specified noninflammatory disorders of vagina Noninflammatory disorder, NOS Vulva Vulvar neoplasm, malignant VIN 3 Vulvar neoplasm, benign Lichen simplex chronicus Prurigo nodularis Lichen sclerosus et atrophicus Localized scleroderma [morphea]

5 Linear scleroderma Sclerodactyly Polyp of vulva VIN I VIN 2 Other specified noninflammatory disorders of vulva and perineum Noninflam dis vulva, NOS Page 2 FREQUENTLY USED Codes Commonly Used ICD-10 Codes in Reproductive Healthcare (cont d) Male Reproductive Healthcare Penile lesion Testicular hypofunction Hypoactive sexual desire disorder Male erectile disorder Premature ejaculation Other sexual dysfunction, not related to substance use /psychological cond. Scrotal varices Radiation proctitis Other specified diseases of anus and rectum Disease of anus and rectum, NOS Allergic contact dermatitis, unspecified cause Irritant contact dermatitis, unspecified cause Unspecified contact dermatitis, unspecified cause Nummular dermatitis Cutaneous autosensitization Other specified dermatitis Dermatitis, unspecified Perifolliculitis capitis abscedens Pseudofolliculitis barbae Other specified follicular disorders Nonspecific urethritis (NGU) Non-specific urethritis Other Urethritis Stress incontinence Post-void dribbling Enlarged prostate without lower urinary tract symptoms Enlarged prostate with lower urinary tract symptoms Prostatitis, acute Prostatitis, chronic Prostatitis, NOS N43.

6 (40/41/42) Spermatocele unspec/single/multiple Hydrocele Torsion of testis, unspecified Epididymitis Orchitis Epididymo-orchitis Infertility, male Adherent prepuce, newborn Phimosis Paraphimosis Deficient foreskin Benign cyst of prepuce Adhesions of prepuce and glans penis Balanoposthitis Other inflammatory diseases of prepuce Other disorders of prepuce N48.(30-39) Priapisms Balanitis Disorder of penis, unspecified Disorder of male genital organs NOS ED due to arterial insufficiency Corporo-venous occlusive ED Male Reproductive Healthcare (cont d) Combined arterial insufficiency and corporo-venous occlusive ED ED due to diseases classified elsewhere Drug-induced ED ED following radical prostatectomy ED following radical cystectomy ED following urethral surgery ED following simple prostatectomy Other post-surgical ED N62 Gynecomastia Pelvic and perineal pain R21 Rash, non-specific skin eruption Urethral discharge w/o blood Hematospermia Urethral discharge unspecified Counseling F17.

7 (200-291) Tobacco Abuse Depressive disorder, single episode Depressive disorder, recurrent Anxiety, generalized Eating disorder, unspecified Decreased libido Z60.(0-9) Problems related to social environment Z71.(41-60) Counseling on substance use/abuse Dietary surveillance and counseling Human Immunodeficiency virus (HIV) counseling Other specified counseling Counseling NOS Complications Postprocedural retroperitoneal abscess R55 Syncope (vasovagal) Drug allergy or hypersensitivity Infection following a procedure Mechanical breakdown of IUD Displacement of IUD Other mechanical complication of IUD Mechanical complication of implant Infection due to IUD/implant in urinary tract Infection due to IUD/implant in genital tract Other Signs and Symptoms Postviral fatigue syndrome Nausea, alone Vomiting, unspecified Vomiting without nausea Projectile vomiting Nausea with vomiting Drug induced fever Drug induced fever Fever, unspecified Neoplastic (malignant)

8 Related fatigue Weakness Other malaise Page 3 FREQUENTLY USED Codes Commonly Used ICD-10 Codes in Reproductive Healthcare (cont d) Infectious Conditions Cervicitis N72 Cervicitis Chlamydia Unspecified site Proctitis (anus/rectum) Pharynx Chlamydial infection of other sites Non-specific urethritis N72 Cervicitis Ectoparasites Pediculosis (crab lice) B86 Scabies Genital Herpes Herpesviral infection of urogenital system, unspecified Herpetic ulceration of penis Herpesviral infection of other male genital organs Herpesviral cervicitis Herpetic vulvovaginitis Herpesviral infection of other urogenital tract Herpesviral infection of perianal skin and rectum Anogenital herpesviral infection, unspecified Ulcer of anus, rectum Genital Warts Anogenital (venereal) warts Viral warts, NOS Molluscum contagiosum HPV infection, unspecified site Gonorrhea (GC) GC infection of lower genitourinary tract, unspecified Cystitis and urethritis, unspecified GC vulvovaginitis, NOS GC cervicitis, unspecified Other GC infection of lower genitourinary tract GC infection of lower genitourinary tract w/ periurethral & accessory gland abscess Infection of kidney and ureter Prostatitis GC infection of other male genital organs GC female PID Other GC genitourinary infections Other GC genitourinary infection Gonococcal pharyngitis Proctitis (anus/rectum) Pelvic Inflammatory Disease (PID) Chronic salpingitis Chronic oophoritis Chronic salpingitis and oophoritis Salpingitis, unspecified Oophoritis, unspecified Salpingitis and oophoritis, unspec.

9 Acute inflamm. disease of uterus Uterus: chronic inflamm. disease Acute parametritis & pelvic cellulitis Chronic parametritis & pelvic cellulitis Unspec. parametritis & pelvic cellulitis PID (Cont d) Female acute pelvic peritonitis Female pelvic peritoneal adhesions (postinfective) Syphilis Primary genital syphilis Condyloma latum Other secondary syphilis of skin Early syphilis, latent Tabes dorsalis Charc t's arthropathy (tabetic) Urinary Tract Infection Chronic tubulo-interstitial nephritis, unspecified N12 Tubulo-interstitial nephritis, not specified as acute or chronic Pyonephrosis Acute cystitis without hematuria Acute cystitis with hematuria Dysuria Painful micturition, unspecified Hematuria, unspecified Frequency of micturition Vaginal Infection Trichomonal vulvovaginitis Candidiasis of vulva and vagina Acute vaginitis Subacute and chronic vaginitis Acute vulvitis Subacute and chronic vulvitis Vulvar Infection & Inflammation Tinea cruris Cyst of Bartholin's gland Abscess of Bartholin's gland Other diseases of Bartholin's gland Acute vaginitis Subacute and chronic vaginitis Acute vulvitis Subacute and chronic vulvitis Abscess of vulva Ulceration of vulva Former V Codes Cervical Cytology Pap to confirm recent normal Pap after abnormal Pap Z08 Vaginal Pap after hyst for cancer Screening Pap smear cervix History of cervical cancer History of abnormal cytology/other abnormal diseases of genital tract Contraception Prescribe oral contraceptives Encounter for emergency cont.

10 Initial Rx of injectable Contraceptive Initial Rx of IUD Initial Rx of other contraceptives Initial Rx of contraceptives, NOS Natural FP to avoid pregnancy Other contraception counseling Sterilization procedure Contraceptive surveillance NOS Surveillance of OC user Surveillance of injectable cont. Insertion of IUD Contraception (Cont d) IUD surveillance Removal of IUD Removal + reinsertion of IUD Surveillance of other contraceptives Other Contraceptive Management Contraceptive Management , NOS Presence of (intrauterine) device Tubal ligation status Vasectomy status Miscellaneous Z23 (Prophylactic) vaccination Natural FP to achieve pregnancy Procreative mgmt. - counseling: preconception care Sexual func. Problem-no psych cond. Pregnancy Evaluation Pregnancy test/exam - not confirmed Pregnancy test/exam, positive Pregnancy test/exam, negative Preventive Medicine Visits General adult medical exam w/o abnormal findings General adult medical exam w/ abnormal findings Gyn.