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Dx for male sterilization consultation

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michelleaapc2012

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Local Chapter Officer
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Cookeville, TN
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Amerigroup-TN recently denied a claim that was billed as 99213 with dx Z30.2 , desire for sterilization, because the TC Ash sterilization consent form was not submitted. The representative I spoke with said the claim was denied because the form was not submitted as required. I explained that this was just the initial visit (consultation) and the consent form will be submitted with the claim for the procedure, CPT 55250. The rep. said DX Z30.2 is inappropriate for this visit or consultation and should only be used with the procedure, CPT 55250. What would be the appropriate DX code then? That is the only reason the patient presented to the office, to discuss and schedule a vasectomy.
 
hi,

I code vas consults/procedures nearly every week.

For consults I use z30.09
for Vas z30.2
semen analysis z98.52

hth :)
 
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