National Women's Health Week: Promote Healthy Choices
Women are different from men and so are some of the health concerns they face. Besides having reproductive health needs and issues, women are at higher risk of being diagnosed with certain diseases than men. According to the Center for Disease Control and Prevention (CDC), heart disease, cancer, and cerebrovascular diseases (stroke) are the leading causes of death among women.
Every year, National Women's Health Week is celebrated in May, starting on Mother's Day. In 2021, this week-long observance runs from May 9 to 16. The goal of National Women's Health Week is to remind women to take better care of themselves and make their health a priority. In addition to focusing on their physical wellbeing, women and girls need to pay attention to their mental health and build psychological resilience to face crises, such as the COVID-19 pandemic. Millions of women have underlying medical conditions that put them at higher risk of severe illness from the virus that causes COVID-19.
Two key points to note about women's health:
- Certain health issues that are common to both men and women affect women differently.
- There are certain high risk medical conditions that affect only women.
Health Issues that Affect Women Differently
While there are various conditions that affect both men and women, certain health issues impact women differently:
- Heart disease: Heart disease is the leading cause of death for men and women in the United States. However, women are more likely to die following a heart attack than men are. The symptoms of heart disease that women experience are different from those common in men.
- Depression and stress: Certain biological, hormonal, and social factors are unique to females. Women are more likely to show signs of depression and anxiety than men. Women can experience certain types of depression at different stages of their life. A survey by the American Psychological Association (APA) found that stress among women is on the rise. Stress can also affect a woman's chance of becoming pregnant.
- Sexually transmitted diseases (STDs): The effects of STDs can be more serious in women. Anatomical considerations increase risk of STD infection in women compared to men. Women are less likely to show symptoms of common STDs, and more likely to misinterpret STD symptoms.
- Pain conditions: Pain conditions that disproportionately affect women include fibromyalgia, irritable bowel syndrome (IBS), rheumatoid arthritis, osteoarthritis, temporomandibular joint disorder (TMJ), chronic pelvic pain, and migraine headache.
- Urinary tract infections: Women are more likely to have urinary tract problems than men.
- According to a CancerConnect article, pancreatic cysts occur more often and differently in women than they do in men, and women are prone to more and different musculoskeletal injuries than are men.
Health Issues that are Unique to Women
- Certain types of cancer: Some cancers are unique to women, such as cervical cancer, ovarian cancer, uterine/endometrial cancer, vaginal cancer, and vulvar cancer. While breast cancer can affect men, it is more common in women.
- Gynecological health issues: Women have to deal with menstruation and menstrual irregularities, urinary tract health, including urinary incontinence and pelvic floor disorders, bacterial vaginosis, vaginitis, uterine fibroids, etc.
- Pregnancy-related conditions: These include pre-pregnancy care and prenatal care, miscarriage and stillbirth, preterm labor and premature birth, and breastfeeding, post-partum infections, pain, breast problems, and more.
- Infertility issues: Causes of infertility can include endometriosis, uterine fibroids, and thyroid disease. Other medical conditions that affect fertility include uterine fibroids, polycystic ovary syndrome, endometriosis, and primary ovarian insufficiency.
Women Health - Diverse Gender-Specific Services
Today, women have access to high quality gender-specific integrated medical care covering a wide range of areas targeting different needs.
Focus areas: Facilities that provide healthcare services for women ensure comprehensive care for the following focus areas:
- Birth control, STDs, and Gynecology
- Breast cancer and other female cancers
- Mammography
- Menopause and hormone therapy
- Osteoporosis
- Pregnancy and childbirth
- Sexual health
- Heart disease
- Conditions affecting the female reproductive organs
Well Woman Visits: The well-woman visit is a preventative measure to help women stay healthy. Preventative care for women includes regular gynecological check-ups, including a pelvic exam and breast exam, hormonal testing for menopause, and healthy lifestyle risk assessment. The annual well-woman visit covers:
- Services, including age-appropriate immunizations, to prevent diseases and other health problems, and improve health
- Screenings, such as cancer screening and screening for STDs, which check for such diseases early when they may be easier to treat
- Education and counseling on health to support informed decision making
Coding Women's Health Services
Specially trained to diagnose, treat, guide, and counsel women, right from adolescence to post-menopause, women's healthcare specialists are dedicated to continually improving the health of all women. While providing high-quality, gender-specific care, providers need to use the right codes to report women's health services.
Diagnosis and Procedure Codes: ICD-10 codes and CPT codes commonly used by women's health specialists are listed below.
ICD-10 codes: - A34 Obstetrical tetanus
- A64 Unspecified sexually transmitted disease
- C52 Malignant neoplasm of vagina
- C55 Malignant neoplasm of uterus, part unspecified
- C58 Malignant neoplasm of placenta
- D25.9 Leiomyoma of uterus, (uterine fibroids)
- E28.2 Polycystic ovary syndrome (PCOS)
- G47.9 Sleep disorder
- N30.10 Interstitial cystitis (chronic) without hematuria
- N39.4 Urinary incontinence and overactive bladder
- N80.9 Endometriosis
- 189.0 Lymphedema
- N73.9 Female pelvic inflammatory disease
- N94.3 Premenstrual tension syndrome
- N72 Inflammatory disease of cervix uteri
- N74 Female pelvic inflammatory disorders in diseases classified elsewhere
- N86 Erosion and ectropion of cervix uteri
- N96 Recurrent pregnancy loss
- O68 Labor and delivery complicated by abnormality of fetal acid-base balance
- O76 Abnormality in fetal heart rate and rhythm complicating labor and delivery
- O80 Encounter for full-term uncomplicated delivery
- O82 Encounter for cesarean delivery without indication
- O85 Puerperal sepsis
- O94 Sequelae of complication of pregnancy, childbirth, and the puerperium
- R10.2 Pelvic and perineal pain
- Z01.411 Encounter for gynecological examination (general) (routine) with abnormal findings
- Z01.419 Encounter for gynecological examination (general) (routine) without abnormal findings
- Z42.1 Encounter for breast reconstruction following mastectomy
CPT codes: - 10004-10012 Fine needle aspiration
- 19081-19086 Breast biopsy, with placement of localization device and imaging of biopsy specimen, percutaneous
- 19281-19288 Placement of breast localization device, percutaneous
- 77046-77047 Magnetic resonance imaging (MRI), breast, without contrast
- 77063 Screening digital breast tomosynthesis
- 77065-77067 Screening mammography; bilateral
- G0279 Diagnostic digital breast tomosynthesis; unilateral or bilateral
- 76641-76642 Breast ultrasound
- 99406 and 99407 Smoking cessation; Smoking cessation counselling
- 59514 Cesarean section (C-section) with a medically indicated diagnosis code supporting reason for cesarean delivery
- 19300-19307 Mastectomy
- 19357-19364 and 19367-19369 Breast reconstruction
- 87624-87625 Human Papillomavirus (HPV) tests
- 88141-88143 Cytopathology, cervical or vaginal (any reporting system)
- 88147-88148 Cytopathology smears, cervical or vaginal; screening by automated system
CPT Codes for Preventive Health Services:
Preventive evaluation and management (E/M) are reported using codes 99381-99397. The CPT preventive codes are grouped by age, and require an age and gender appropriate history, examination, and counseling/anticipatory guidance: - 99381 New patient – Initial preventive medicine visit, infant (age younger than 1 year)
- 99382 New patient – Initial preventive medicine visit, early childhood (1-4 years)
- 99383 New patient – Initial preventive medicine visit, late childhood (5-11 years)
- 99384 New patient – Initial preventive medicine visit, adolescent (12-17 years)
- 99385 New patient – Initial preventive medicine visit, 18-39 years
- 99386 New patient – Initial preventive medicine visit, 40-64 years
- 99387 New patient – Initial preventive medicine visit, 65 years and older
- 99395 Established patient – Periodic prev. medicine visit, 18-39 years
- 99396 Established patient – Periodic prev. medicine visit, 40-64 years
- 99397 Established patient – Periodic prev. medicine visit, 65 years and older
In addition to staying up to date on the codes, providers need to ensure documentation to support preventive services. CPT specifies these services to include “an age and gender appropriate history, examination, counseling/anticipatory guidance/risk factor reduction interventions, and the ordering of laboratory/diagnostic procedures."
The patient's age will determine the extent and focus of the services. For example, for a 40-year-old female, a preventive services exam would include blood pressure, height, weight, BMI, depression screening, eyes, ENT, cardiovascular, respiratory, GI, GU, musculoskeletal, skin, neurological, psychological, hematological, and screening for breast cancer, cervical cancer. Likewise, osteoporosis screening is recommended in women 65 years and older, and in younger women with a similar risk of fracture.
The documentation should very clearly show that the elements of the annual preventive service were met. A separate problem-oriented E/M service may be reported only if decisions are made as to how to treat the patient to improve control of a worsening chronic condition.
Measures to Promote Physical and Mental Health
With the manifold health conditions and risks that they face, women should pay special attention to their physical and mental wellbeing. While some risk factors are genetic, others are related to lifestyle. Steps to take:
- Understand your risk factors.
- Take steps to minimize these risks: eat well-balanced meals, exercise regularly, maintain a healthy weight, take care of mental health, find ways to relieve stress, get adequate sleep, quit smoking, avoid drugs, and control alcohol intake.
- Consult your physician if you have concerns about COVID-19 or any other physical or mental health issue, or to manage medical conditions such as diabetes, asthma, blood pressure, or obesity.
- Use medications correctly. Medicines can cause serious health problems if not used as they should be.
- Keep your regular health check-ups. Primary care and preventive care are crucial, more so during a pandemic. Internists and family medicine specialists provide general gynecologic examinations. If there are specific gynecologic concerns, your primary care provider will refer you to a women's health specialist or gynecologist.
National Women's Health Week is the ideal time for women to commit to achieving these goals.
Natalie Tornese, CPC, is a Senior Group Manager responsible for Practice and Revenue Cycle Management at MOS. She brings 25 years of healthcare management experience to the company. Natalie has worked in varied leadership roles with practices and specialties. Her primary focus is revenue cycle management with an emphasis on Medical Billing, Coding, and Insurance Verification Management.
She has written numerous articles on all aspects of Practice Management and presently manages a large team focused on Medical Billing, Medical Coding, Verification, and Authorization services for MOS. For more information on how MOS can help your practice, contact us at 1-800-670-2809 or visit us at ( www.outsourcestrategies.com).
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