Proper Medical coding and billing is important to the financial health of your practice!
Medication codes:
Administration code
Please avoid using the regular 96372 administration code. Instead use the following administration code: G0012
This code is used when the provider physically administers the PrEP medication.
Supply Code
For the oral PrEP pharmacies should bill: Q0251
ICD-10 codes:
F19.10, F19.20, Z11.3, Z11.4, Z20.2, Z20.6, Z29.81, Z72.51- Z72.53, Z72.89, Z79.899
These services are classified as preventative medicine.
Based on which insurance payers your office accepts, there can be some variations of coverage to the additional services that may be related to PrEP. Please make sure you check with the insurance payers before performing any services for additional coverage information.
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