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Urology Coding Alert

Confirm Vasectomy Procedure Coverage Before Coding

Published on Wed Jun 17, 2009

Tip: Collecting a deposit can cut down on your no-shows. Some payers won't reimburse you for vasectomy procedures at all, so your first step should be to check with your payers to see if they will pay your urologist for the vasectomy codes you report. Check Coverage or Ask the Px to Verify Benefits "We do have some payers who don't pay for vasectomies," says Alice Kater, CPC, PCS, coder for Urology Associates of South Bend, Ind. "For example, we are near a Catholic university, and their insurance does not cover voluntary sterilization. Even though we are participating providers, we feel comfortable collecting up front for these surgeries as they are a noncovered benefit." Medicare does not pay for vasectomies, cautions Kelly Young, a coder with Scottsdale Center for Urology in Scottsdale, Ariz. According to Medicare National Coverage Determinations Manual, Chapter 1, Part 4, Section 230.3, elective vasectomies are not [...]
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