Results 1 to 2 of 2

Post essure confirmation

  1. #1
    Exclamation Post essure confirmation
    Medical Coding Books
    I am getting mixed answers on the Post Essure Confirmation test (HSG) and how its being billed/paid. We typically bill as follows:

    58340 v67.09 v26.51
    74740 v67.09 v26.51

    When we bill, it typically goes towards the patient's surgical benefits, and they are stuck paying the deductible. According to ACA, the Essure procedure should be covered at 100%, in which it is when the device is implanted. We do not implant the Essure, we ONLY DO the confirmation test. I have had a few patients these last few weeks dispute their deductible amount, and state that it should be covered 100%. They are blaming the way that the procedure is being billed, however, again, when we verify, the carriers are telling us it hits deductible. Does anyone bill differently and have it covered for patients? Should we be adding a modifier (-33 maybe) to indicate that this is the confirmation???

    Any adivse on this is MUCH appreciated.

  2. #2
    Have you checked the Essure website,, for information? They usually have a reimbursement section that explains how they think this should be billed. Not to say that is going to get the claim paid but I always reference the manufacturer's website when I have questions about their product. Hope that helps!
    Leandra Tufts, CPC, CPMA, CEMC, COBGC

Similar Threads

  1. Essure ?
    By RebeccaB in forum OB/GYN
    Replies: 1
    Last Post: 09-05-2013, 10:03 AM
  2. Essure confirmation test
    By ssmith92691 in forum OB/GYN
    Replies: 1
    Last Post: 01-14-2013, 10:32 AM
  3. ICD-9 confirmation
    By kimlanunziata in forum Diagnosis Coding
    Replies: 2
    Last Post: 01-08-2013, 03:44 AM
  4. Essure
    By cstoldt in forum OB/GYN
    Replies: 3
    Last Post: 03-22-2012, 09:44 AM
  5. Essure
    By jesslyn311 in forum OB/GYN
    Replies: 6
    Last Post: 01-04-2010, 12:22 PM

Posting Permissions

  • You may not post new threads
  • You may not post replies
  • You may not post attachments
  • You may not edit your posts
Enjoying Our Forums?

AAPC forums are a benefit of membership. Joining AAPC grants you unlimited access, allowing you to post questions and participate with our community of over 150,000 professionals.

Join Now Continue Reading Without Full Access

Already a Member?


Close Message

In addition to full participation on AAPC forums, as a member you will be able to:

  • Access to the largest healthcare job database in the world.
  • Join over 150,000 members of the healthcare network in the world.
  • Be a part of an industry leading organization that drives the business side of healthcare.
  • Save anywhere from 10%-50% with exclusive member discounts on courses, books, study materials, and conferences.
  • Access to discounts at hundreds of restaurants, travel destinations, retail stores, and service providers. AAPC members also have opportunities to save on heath, life, and liability insurance.
  • Become a member of a local chapter and attend regular meetings.