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Coding undiagnosed infertility

  1. Default Coding undiagnosed infertility
    Medical Coding Books
    Needing to brainstorm: We have a patient who has been unable to concieve in 8-10 months. To diagnose a patient as infertile it should be over 1 year of trying. Most insurances will not pay for infertility so I need to be careful not to "label" this patient. We are going to send her for a sonohysterogram and need to provide the dx code. I thought possibly V81.6 may be the best (even though it most likely will not be paid)...she has not had any problems, regular periods, no pain, nothing, no symptoms what so ever. Any ideas?

  2. #2
    V26.29 would be my suggestion and I think the patient should be prepared to pay for it.

    Laura, CPC, CEMC

  3. #3
    North Carolina
    Food for thought...our Infertility Specialist submits V26.21

  4. Default
    Thank you both! I do like the V26.29 a little better because we do not want to suggest that she is infertile at this time, and maybe we will be lucky and something will be found on the sonohyst. Thanks again!

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