CDP Coding and Billing . Family Planning Program January 25, 2012. Importance of accurate coding. Maximize reimbursement from third party insurers, including public (Medicaid) and private (Humana, Blue Cross, etc) Maximize fee collection Donations
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Family Planning Program
January 25, 2012
Maximize revenue for your family planning services by assuring all services are coded accurately and to the highest level provided.
Statewide over $400,000 in revenue were collected from private insurers for FPP.
- total number of unduplicated FP users served in the calendar year
- Title X allocations based on number served at state, regional, and federal levels
- CDP runs the FPAR Mid Year and Final Calendar year based on the information entered on each patient’s registration and PEF
CONTRACEPTIVES, QUANTITY ISSUED and LOT#:
All contraceptive methods being administered during a Family Planning Visit must be reported as an “S”, “J” or CPT code.
PEF entry for methods dispensed must be put in CHG/QTY field! DO NOT USE UNIT FIELD
Use when V25 ICD-9 is coded in any position (STD, Adult/Child, Cancer visits) and NO method is dispensed at visit,
OR a prescription is written for a method
PRIMARY METHOD PATIENT IS USING IF NO METHOD GIVEN TODAY:
The “2” digit codes are used only for Family Planning Visits where no contraceptive method is given to the patient. For reporting purposes only, these “2” digit codes are used to identify what contraceptive method the patient is using. Place a check in the box preceding the appropriate method.
It is recommended to enter a V25 code to cover family planning counseling or method provided
Assure level of visit is equal to amount of service provided as required in PHPR, FP Matrix for pregnancy test and ECP visits
AR, PSRS, Page 137
Primary V25 codes with edit to 802 Family planning. If you provide pregnancy prevention counseling or assess for pregnancy risk at a STD, child or adult preventive exam, code a V25 in the secondary position (so you get credit for it on FPAR)!!
Examples of secondary coding adult/child preventive, STD, Post Partum visits
V2509 Family Planning Advice/Counseling
Debra Israel, RN
Director Family Planning Program
Division for Women’s Health
(502) 564-3236, Ext: 4590
Fax: (502) 564-1552