tci ED Coding & Reimbursement Alert - 2001 Issue 6

Reader Question: Morning-after Diagnosis Code

Question: We have recently seen several cases of patients presenting to the ED for the morning-after pill, RU-486. In some cases it was administered, in others it was not. What would be the correct diagnosis code?Virginia SubscriberAnswer: The diagnosis code would be V25.01 (prescription of oral contraceptives), but receiving RU-486 may not meet payer medical-necessity guidelines and may not be reimbursed in the ED. Answers for Reader Questions and You Be the Coder provided by Caral Edelberg, CPC, CCS-P, president of Medical Management Resources Inc., an emergency department coding consulting firm in Jacksonville, Fla., and Todd Thomas...

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