Family Planning and Title 10 Resources

Check out the RHNTC website for lots of updated financial resources including coding and billing that may be helpful to your agency and staff.

Click here for rhntc.org/resources

NYS Family Planning FAQ Updated April 2023

Here is the latest version of the NYS Medicaid Family Planning and Reproductive Health Services FAQ updated April 2023 FAQ

COVID PHE ending May 11, 2023

Based on current COVID-19 trends, the Department of Health and Human Services is planning for the federal Public Health Emergency for COVID-19 (PHE), declared under Section 319 of the Public Health Service Act, to expire at the end of the day on May 11, 2023. This may impact billing for telehealth, COVID vaccines and testing and other services. PLease carefully monitor payer updates for new guidance and changes.

New ICD Codes for Under-Immunized Status

Effective April 1, 2022: Two new ICD-10-CM codes have been created for under-immunization for COVID-19 status:

• Z28.310 Unvaccinated for COVID-19

• Z28.311 Partially vaccinated for COVID-19

A third new code describes other underimmunization status:

• Z28.39 Other underimmunization status

Additional codes are assigned, if applicable, to provide additional reasons for underimmunization, such as contraindication (Z28.0-) or the patient’s decision for reasons of belief or group pressure (Z28.1).

The new code for “other underimmunization status” includes delinquent immunization status and lapsed immunization schedule status.

The new codes for underimmunization for COVID-19 status should not be assigned for individuals who are not eligible for the COVID-19 vaccines (e.g., children under age 5).

The ICD-10-CM Official Guidelines for Coding and Reporting have been updated to provide guidance regarding the use of the new ICD-10-CM codes. Code Z28.310, Unvaccinated for COVID-19, may be assigned when the patient has not received at least one dose of any COVID-19 vaccine. Code Z28.311, Partially vaccinated for COVID-19, may be assigned when the patient has received at least one dose of a multi-dose COVID-19 vaccine regimen but has not received the full set of doses necessary to meet the CDC’s definition of “fully vaccinated” in place at the time of the encounter.

https://journal.ahima.org/page/new-icd-10-cm-pcs-codes-become-effective-april-1

New HCPCS codes for vaginal ring contraceptives (Annovera vs. Nuva rings)

Effective October 1, 2021 there are 2 new codes for vaginal rings:

• Code J7294 “Segesterone acetate and ethinyl estradiol 0.15mg, 0.013mg per 24 hours; yearly vaginal system, each” (Annovera)

• Code J7295 “Ethinyl estradiol and etonogestrel 0.015mg, 0.12mg per 24 hours; monthly vaginal ring, each” (Nuva ring etc.)

HCPCS Level II code J7303 “Contraceptive supply, hormone containing vaginal ring, each,” has been discontinued for billing effective September 30, 2021.

Please review your billing systems to ensure your codes / charges are up-to-date to ensure accurate billing and reimbursement.

New CPT code "0003A" for third dose of Pfizer COVID-19 vaccine

For quick reference, the vaccine administration CPT code and long descriptor assigned to the third dose of the current Pfizer COVID-19 vaccine is:

0003A
Immunization administration by intramuscular injection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccine, mRNA-LNP, spike protein, preservative free, 30 mcg/0.3 mL dosage, diluent reconstituted; third dose.

Learn more at AMA