What is the diagnosis code for taking Plan B (levonorgestrel)?

Diagnosis Code for Plan B (Levonorgestrel) Emergency Contraception

The appropriate ICD-10 diagnosis code for taking Plan B (levonorgestrel) emergency contraception is Z30.012 (Encounter for prescription of emergency contraception).

Understanding Emergency Contraception Coding

Emergency contraception with levonorgestrel (Plan B) is classified under the Z30 family of codes, which covers contraceptive management. This specific code accurately captures the clinical encounter for emergency contraception provision.

Key Points About Plan B (Levonorgestrel):

• Plan B is a progestin-only emergency contraceptive containing 1.5mg of levonorgestrel 1
• It can be taken as a single 1.5mg dose or as two 0.75mg doses 12 hours apart 2
• Most effective when taken as soon as possible after unprotected intercourse, but can be used up to 5 days post-coitum 2
• Works primarily by inhibiting or delaying ovulation when administered before the LH surge 2

Coding Considerations

When documenting the encounter for Plan B:

1. Use Z30.012 as the primary diagnosis code
2. Document the reason for emergency contraception (if applicable)
3. Include any relevant counseling provided

Clinical Context for Coding

• Plan B is not intended as a regular contraceptive method 2
• The CDC's Selected Practice Recommendations for Contraceptive Use supports having an advanced supply of emergency contraception to minimize treatment delays 3
• Plan B has a moderate efficacy rate, preventing approximately 80% of pregnancies when used correctly 2

Common Pitfalls to Avoid

• Do not use codes for regular contraceptive management (Z30.011, Z30.019) for emergency contraception
• Avoid using symptom codes as primary diagnoses when the encounter is specifically for emergency contraception
• Do not confuse with codes for other types of contraceptives like IUDs or implants

Documentation Tips

For proper coding and reimbursement, ensure documentation includes:

• Specific mention of emergency contraception provision
• Counseling on proper use and expectations
• Any side effects discussed (nausea, vomiting, headache, breast tenderness, menstrual changes) 2
• Follow-up recommendations if applicable

Remember that Plan B is available over-the-counter to patients of any age 1, but when prescribed or administered in a clinical setting, proper diagnosis coding is still required.