Ob-Gyn Coding Alert

Reader Questions:

Stick to This Sterilization Coding Advice

Question: What should I use for a multiparity diagnosis and Falk procedure? I used V25.2 for multiparity and 58670 for the procedure, but the insurance is denying this. Why? What should I use?

Texas Subscriber

Answer: Your codes (58670, Laparoscopy, surgical; with fulguration of oviducts [with or without transaction]; and V25.2, Sterilization) should work. The insurer may be denying the procedure because the patient does not have coverage for sterilization procedures. Also, you may need to get prior authorization. 

Note: Despite V61.5 (Multiparity) being a secondary diagnosis, you could use it to indicate her reason for wanting the procedure. This is still a sterilization procedure, so you must report V25.2.