Family Planning Codes with Increased Rates
MHCP-covered family planning procedure codes in the table below receive the following legislative rate increases:
Code | Description |
00840 | Anesth, surg low abdmn |
00851 | Anesth, tubal lig/transect |
00920 | Anesth, genitalia surgery |
00921 | Anesth, vasectomy |
00952 | Anesth, uterine endo |
11976 | Remove of contracep cap |
11981 | Insert drug implant device |
11982 | Remove drug implant device |
49320 | Diag laparo sep proc |
49321 | Laparoscopy, biop |
49329 | Lap proc, abdm/per/omentum |
52010 | Cystoscopy & duct cath |
54500 | Biop testis, needle |
54505 | Biop testis, incis |
54830 | Excise epididymis lesion |
54865 | Explore epididymis |
54900 | Fuse sperm ducts, unilatl |
54901 | Fuse sperm ducts, bilat |
55200 | Vas cannul w/wo incis |
55250 | Vas, uni/bilat postop semen exam |
55300 | Prep for sperm duct x-ray |
55450 | Ligate sperm duct |
55520 | Excis sperm cord les |
55530 | Revise sperm cord veins ( |
55535 | Revise sperm cord veins abd |
55540 | Excis hernia & sperm veins |
55600 | Vesiculotomy |
55605 | Vesiculotomy; complicated |
55680 | Excis Mullerian duct cyst |
55870 | Electroejaculation |
57150 | Vag irrigate/med app tx |
57170 | Fit diaphragm/cap ( |
57410 | Pelvic exam under anesth |
57505 | Endocervical curettage |
57700 | Revision of cervix |
57720 | plastic repair cervix |
57800 | Dilation of cervical canal |
58100 | Biopsy uterus lining |
58120 | Dilation & curettage |
58140 | Myomectomy abd approach |
58145 | Myomectomy vag approach |
58300 | Insertion IUD |
58301 | Remove IUD |
58340 | Inject for ut/tube x-ray |
58345 | Reopen fallopian tube |
58350 | Chromotubation oviduct |
58400 | Uterine suspension |
58540 | Hyseroplasty, (Strassman) |
58555 | Hysteroscopy, diagnostic |
58558 | Hysteroscopy, biopsy |
58559 | Hysteroscopy, lysis |
58560 | Hysteroscopy resect septum |
58561 | Hysteroscopy remove myoma |
58565 | Hysteroscopy bi tube cannul |
58600 | Ligate/transect tubal, ab/vag |
58605 | Lig/tran tubpostpart same stay |
58611 | Ligation oviduct(s) |
58615 | Fal tube occlusion w device |
58660 | Laparoscopy lysis |
58670 | Lap w fulg ovid w/wo transect |
58671 | Lap w occlus ovid by device |
58672 | Laparoscopy fimbrioplasty |
58673 | Laparoscopy salpingostomy |
58700 | Salpingectomy |
58740 | Lysis of adhesions |
58752 | Revise ovarian tube(s) |
58760 | Fimbrioplasty |
58770 | Salpingostomy |
58825 | Transposition, ovary(s) |
58900 | Biopsy of ovary |
58920 | Wedge resec/bisect ovar |
74000 | Rad exam, abd 1 anteropost |
74740 | Hysterosalpingography |
74742 | X-ray fallopian tube |
76856 | Echography pelvic complete |
76857 | Echography pelvic |
76870 | Echography scrotum |
76872 | Ultrasound transrectal |
76948 | Echo guide ova aspiration |
77080 | DXA axial |
77081 | DXA appendicular |
93975 | Vascular study |
93976 | Dup scn flw art in&ven out |
96372 | Ther/proph/diag inj, sc/im |
99078 | Grp health ed |
99201 | Office/outpt visit–new pt |
99202 | Office/outpt visit–new pt |
99203 | Office/outpt visit–new pt |
99204 | Office/outpt visit–new pt |
99205 | Office/outpt visit–new pt |
99211 | Office/outpt visit–new pt |
99212 | Office/outpt visit–est pt |
99213 | Office/outpt visit–est pt |
99214 | Office/outpt visit–est pt |
99215 | Office/outpt visit–est pt |
99241 | Office consultation |
99242 | Office consultation |
99243 | Office consultation |
99244 | Office consultation |
99245 | Office consultation |
99384 | Prevent visit new 12-17 |
99385 | Prevent visit new 18–39 |
99386 | Prevent visit new 40–64 |
99394 | Prevent visit est 12-17 |
99395 | Prevent visit est 18–39 |
99396 | Prevent visit est 40–64 |
99401 | Prev counsel indv 15 min |
99402 | Prev counsel indv 30 min |
99403 | Prev counsel indv 45 min |
99404 | Prev counsel indv 60 min |
99411 | Prev counsel grp 30 min |
99412 | Prev counsel grp 60 min |
A4261 | Cerv cap contracep |
A4266 | Diaphragm |
A4267 | Male condom |
A4268 | Female condom |
A4269 | Spermicide |
G0433 | Elisa HIV-1/HIV-2 screen |
H1010 | Nonmed fam plan ed |
J0561 | Inj pen G benz to 2.4 mil |
*J0696 | Inj ceftriaxone sodium |
J1050 | Medroxyprog acet 1 mg inj |
J7297 | Levongestrel IUD (52 mg 3 yr) |
J7298 | Levongestrel IUD (52 mg 5 yr) |
J7300 | copper IUD |
J7301 | Levongestrel IUD (13.5 mg) |
*J7302 | Levonorgestrel IUD system |
*J7303 | Contracept vaginal ring |
*J7304 | Contracept patch |
J7307 | Etonogestrel impl system |
*J8499 | Prescription drug, oral, NOS, non-hormonal OC/EC: Use to report CDC recommended drugs for treatment of STIs when dispensed in the office, for example Amoxicillin, Cefixime, Ciprofloxacin, Clindamycin, Clotrimazole, Doxycycline, Fluconazole, Metronidazole, Nitrofurantoin, Ofloxacin, Sulfa-methoxazole/Trimethoprim, Terconazole. |
Q0090 | Levonorgestrel IUD system (13.5 mg) |
Q0091 | Pap smear |
*S4989 | Contracept IUD |
*S4993 | Contracept BC pills (hormonal) |
T1013 | Oral language interp |
*Indicates the HCPCS code requires an NDC, dispensing unit, and quantity when billing MHCP. Refer to HCPCS Codes Requiring NDC.
MHCP Provider Call Center 651-431-2700 or 800-366-5411; TDD: 7-1-1
https://mn.gov/dhs/partners-and-providers/policies-procedures/minnesota-health-care-programs/provider/
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