Preconception Counseling
Preconception counseling is an office consultation to discuss the potential risks a woman may face when pursuing pregnancy. Discussion typically involves identifying risk factors that could impact the progress of a healthy pregnancy and healthy fetus. Addressing issues ahead of time, such as nutrition, weight gain or weight loss, diabetes management, hypertensive management and medication exposures, can avoid harm during this crucial embryogenic period.
Multiple national organizations encourage patients to seek preconception counseling. ACOG recommends that all women at risk consider a preconception consult, as during the first 8 weeks of pregnancy all major fetal organs form, before a woman may even know she has become pregnant. The CDC also endorses preconception counseling through their Preconception Health and Preconception Health Care National Initiative. Additionally, the Department of Health and Social Services has initiated their Preconception Health Campaign which includes creating a Reproductive Life Plan with your physician. Although preconception counseling is usually for women who have never been pregnant, all national organizations note that even women who have previously conceived can benefit from preconception counseling. This is an important and valuable first step on the road to a healthy pregnancy.
From a coding perspective, preconception counseling is typically coded as an outpatient consultation or visit. The diagnosis code should accurately reflect the reason for the encounter. ICD-10 code Z31.69 is the appropriate code to use for these services, along with any condition or risk factor involved.
Z31.69 is defined as “Encounter for other general counseling and advice on procreation”.
It is important to note that code Z31.69 encompasses a variety of procreative counseling, including:
Counseling procreative management, medication discussion
Counseling, infertility
Infertility counseling
Infertility counseling done
Infertility counseling done (situation)
Preconception counseling
Preconception counseling done
Preconception counseling done (situation)
Preconception management, desires sterilization reversal
Preconception management, medication discussion
Procreative management for desired sterilization reversal done
Procreative management for desired sterilization reversal done (situation)
Procreative management with medication discussion done
Procreative management with medication discussion done (situation)
Procreative management, sterilization reversal desired
Because ICD-10 code Z31.69 covers several types of procreative counseling, it is important to distinguish this encounter from infertility counseling or other types of counseling.
For instance, a patient presents for preconception counseling, because she has essential primary hypertension. The ICD-10 codes to use are:
I10 Essential (primary) hypertension
Z31.69 Encounter for other general counseling and advice on procreation