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O.4.2.2 Office or Other Outpatient Visit
Providers may use the following procedure codes with modifier FP and a WHP diagnosis for other family planning office or outpatient visits:
The above procedure codes are allowed for routine contraceptive surveillance, family planning counseling and education, contraceptive problems, suspicion of pregnancy, genitourinary infections, and evaluation of other reproductive system symptoms. Depending on the extent of the services provided during the office visit, providers may bill for the maximum allowable fees.
During any visit for a medical problem or follow-up visit the following must occur:
• An update of the client's relevant history.
•Physical exam, if indicated.
•Laboratory tests, if indicated.
•Treatment or referral, if indicated.
•Education/counseling or referral, if indicated.
•Scheduling of office or clinic visit if indicated.
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