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Wiki Surgical Pathology diagnosis

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renesmartpro

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Need assistance with a billing question--Fallopian tube segments - Lumen identified - no significant pathological changes
What Diagnosis code would I use? V25.2 keeps getting denied by insurance carriers stating 'Diagnosis code not valid for benefit'
 
Wish I could help. V25.2 is the code we use with no problems. My only thought is whether tubal ligation is a covered benefit to these patients. Hopefully you can get more details about the denials from the insurance carriers who are denying.
 
One other thought - did you submit with 88302 (which is the correct CPT)? 88302 X 1 if both tubes submitted as one specimen, 88302 X 2 if submitted as separate specimens.
 
We did submit with the 88302 * 2 the problem is that because the patient is electing for the sterilization, Medicaid or any Medicaid affiliiate will not pay for the pathology testing.
 
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