Preventive Care Coding Summary (Women's Preventive Health)
Defines preventive care procedure, diagnosis, and billing codes and coverage notes for women's preventive health services for Sierra Health and Life members.
No material clinical or coverage changes in this revision.
Coverage Criteria for Women's Preventive Services
Coverage criteria for women's preventive services
Covered when the following service-specific conditions and limits are met:
ALL of the following
- Applicable procedure codes: 59400, 59510, 59610, 59618 (global obstetrical) and prenatal visit codes 59425, 59426
- Note: The routine, low-risk prenatal visits portion of the Global Obstetrical code is covered as preventive
ALL of the following
- Applicable procedure codes: 82947, 82948, 82950, 82951, 82952, 83036, 36415, 36416
- Required diagnosis: pregnancy diagnosis (see pregnancy diagnosis list)
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