Elderly Positive Pregnancy Test; Z32.01?

sbethea

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I have an elderly patient that tested positive for pregnancy. I used Z32.01 but it was rejected by our Clearing House. When I researched the code on the internet, it stated that it should be used in patients 12-55 years old; however, I don't see this age restriction in the ICD-10 manual. Is there another positive pregnancy test code I should be using or should I try to push the claim through?
 

tracylc10

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If you look at the code in the CPT you will see a tiny M next to the symbol for female, if you look at the bottom of the page for the explanation of the symbols, you will see the M and that it stands for Maternity Age: 12-55.

If the pt is over 55, I would try and push it through and maybe send notes/results along with. Not sure if making a call to the insurance would help or not, but you could call them as well, maybe they could flag her in their system or something.
 

sbethea

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I didn't notice the "M" next to code. I see it now. Thank you! I don't understand why they would put a max or min age on positive pregnancy test codes and not provide an alternative; clearly there will be exceptions.
 
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I didn't notice the "M" next to code. I see it now. Thank you! I don't understand why they would put a max or min age on positive pregnancy test codes and not provide an alternative; clearly there will be exceptions.

They base the range on average expected ages; right now it's 12-15 for menarche and 45-55 for the beginning of menopause.
 
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