Wiki IUD insertion under anesthesia

[nsteinhauser]

Patient presents for placement of Mirena IUD under ultrasound guidance in OR. Has "history of pain, trauma and anxiety form previous GYN exams in clinic."
58300 is an office based procedure. I'm wondering if anyone knows of any ICD-10 dx codes to use to indicate the medical necessity of doing this in an OR under anesthesia, versus in an office?
Thank you in advance for any help.

 

[nielynco]

Patient presents for placement of Mirena IUD under ultrasound guidance in OR. Has "history of pain, trauma and anxiety form previous GYN exams in clinic."
58300 is an office based procedure. I'm wondering if anyone knows of any ICD-10 dx codes to use to indicate the medical necessity of doing this in an OR under anesthesia, versus in an office?
Thank you in advance for any help.

The code 59300 may be reported in either a facility or non-facility setting. You will get fewer RVUs in the facility setting, however. As to a diagnosis code, you may have to look at the mental health codes such as F41.1 (general anxiety disorder). Or perhaps a Z code Z91.49, Other personal history of psychological trauma, not elsewhere classified.

 

[nsteinhauser]

Thank you. I think the Z91.49 is appropriate. It seems as though the payers don't want to allow anything for facility charges on these insertions.
Thanks again.