CDP Coding and Billing Preconception Care / Folic Acid Program

1. CDP Coding and Billing Preconception Care / Folic Acid Program January 25, 2012

2. Preconception Care / Folic Acid Program • Guidelines outlined in the PHPR - Preconception/Folic Acid Section • Program description outlined in the Administrative Reference (Volume I, Program Descriptions, Section II, Page 99) - Preconception Health Care and Folic Acid Supplementation Program • Training guidelines outlined in the Administrative Reference (Volume I, Training Guidelines, Section I, Page 4) - Folic Acid TRAIN Module, course # 1017232

3. Preconception Care / Folic Acid Program Preconception care (including folic acid supplementation) should be offered to ALL female patients of childbearing age, who have not had a hysterectomy or tubal ligation, during their initial and annual Family Planning visits as well as during adult preventative visits.

4. Preconception Care / Folic Acid Program Visit Codes: • V2689 (Preconception/Folic Acid Counseling) • V1369 (History of Congenital Malformation) DO NOT use 2662- (folic acid deficiency) Diagnosis code - LHD do not test patients to determine folic acid deficiency.

5. Folic Acid Supplementation Initial folic acid counseling includes NTD prevention education and offering one bottle (3 month supply) of multivitamins containing .4 mg (400 mcg) of folic acid for free. • Agencies may choose to give patients requesting refills on multivitamins additional bottles for free, or choose to charge for an additional bottles. • Agencies may choose to give patients more than one bottle at a time. • If more than one bottle is distributed to a patient at a time, include the quantity beside the appropriate code on the PEF.

6. Folic Acid Supplementation Coding: W0506 - 1 bottle (3 month supply) of multivitamins given free with initial folic acid counseling W0506FR - Additional bottle (3 month supply) of multivitamins with no charge to the patient W0506CH - Additional bottle (3 month supply) of multivitamins charged to patient

7. Folic Acid Supplementation Funded by Tobacco Settlement Money – Over recent years, the funding for the folic acid program has steadily decreased: • Fiscal Year 2008 - $400,000 • Fiscal Year 2009 - $300,000 • Fiscal Year 2010, 2011, 2012 - $200,000 Funds are running out well before the end of each fiscal year.

8. Folic Acid Supplementation Changes to the fee amount for service reimbursement: • Folic Acid Counseling (V2689) and a three month supply of multivitamins (W0506) – from $5.25 to $3.50 • Folic Acid Counseling (V2689) only – from $4.00 to $2.00 • MVI (W0506, W0506FR, W0506CH) – from $1.25 to $1.50

9. Folic Acid Supplementation Changes to the grant allocation reimbursement payment schedule: Each local health department’s folic acid program allocation will be divided into 12 equal monthly payment caps to be reimbursed throughout the fiscal year.

10. Folic Acid Supplementation • For women who have a history of Neural Tube Defect pregnancy, refer to the guidelines outlined in the PHPR Preconception/Folic Acid Section pages 3&4. • These women will need a prescription dose of folic acid. • Diagnosis Code: V1369 (History of Congenital Malformation)

11. Questions • Emily Adkins, RN Nurse Consultant Family Planning - Preconception Health Division of Women's Health 275 East Main Street, HS1WF Frankfort, KY 40621 502-564-3236 x 3822 Fax: 502-564-1552 Emily.Adkins@ky.gov