Wiki Sterilization ICD-10/Consent Forms Medicaid

[jtessmer@aipathology.com]

A big issue we are coming across with Medicaid is that we are required to track down the sterilization consent form from the referring provider in order to get paid for sterilization specimens (vas deferens, fallopian tubes), but if the referring physician does not have the patient complete a consent form, if the form is incomplete in any way, or if it was not submitted with our claim within 30 days, they refuse to pay.
What ICD-10 code are you using for sterilization specimens for your lab? Are you getting paid by Medicaid? We are in Wisconsin.

Thanks in advance!

 

[danachock]

sterilization forms woes

Sorry but WI is super relentless on this issue; if you want to get paid you need the documentation! And I'm from Minnesota with plenty of denial (multi specialty) experience. Whoever is acquiring your specimens (lab/path dept specialist) needs to be on the upside of this. They need to be calling and obtaining this documentation at the point the specimen is received (no delays). AND IT NEEDS TO BE SCANNED INTO THE PATIENT'S MEDICAL FILE.
If the facility that presented the specimen doesn't have it .......(yes it REALLY sucks) then so be it. Goodness what other code are you hoping for? I can reassure you that no provider wants to provide an interpretation on something they won't be reimbursed for. Maybe if you or you lab/path manager is a pain in the ass of the facility providing all these woes they won't be woes anymore?? Step up and educate the providers or reach out; they want to get paid their TC RVUs too. It's possible they don't realize that they are not getting paid. Seriously the majority of the providers I have ever reached out to really do care.
Hang in there & don't give up;
Dana Chock

 

[jtessmer@aipathology.com]

Thank you!