Coding, Classification and Reimbursement

  • 1.  Preventive Womans Exam

    Posted 01-07-2019 08:49


    Our student insurance through Anthem is denying all of our preventive woman's exams billed as: CPT: 99395 ​​with DX Z01.419, Z30.41.

    Under the main heading ( persons encountering health services for examinations) in the ICD 10 book there is an excludes 1 note stating: examinations related to pregnancy and reproduction ( Z30-Z36,Z39). But under Z01.4 their is an excludes 2 note stating: routine exam for contraceptive maintenance.

    So from my understanding, we are billing these correctly based off the excludes 2 note?

    Thank you,

    Brooke Mason, CCA

    Brooke Mason
    Medical Billing and Coding Coordinator