Wiki ICD 10 code for 55250 Vasectomy

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1CodingTeam24

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Hello,

Can you please tell me the ICD 10 code for CPT code 55250?

We have been using Z30.2 Encounter for Sterilization but we are receiving some requests for more documentation and unsure if maybe Z98.52 Vasectomy status maybe a better diagnosis code to use.

Thank you in advance for your help.
 
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Z30.2 is the correct diagnosis code. Z98.52 would not be the correct code if the patient is having a vasectomy (55250), because it's used for patients who've had the procedure already. If insurance is requesting documentation, provide it.
 
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I agree, Z30.2 should be all that's necessary. Some payers do require a copy of the patient consent for any sterilization procedures. If that's the kind of documentation they're seeking, it's best to just send that along with the initial submission of the claims.
 
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Just a follow-up question, I am just trying to clarify if 55250 Vasectomy is always considered to be a medically necessary procedure?
**Per CMS Guidelines that in order for a payment to be made on this procedure it should be documented as an illness or injury and not an elective procedure.
Thank you.
 
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