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Thread: Pregnancy test

  1. #1
    Join Date
    Apr 2007
    Barren River Area

    Default Pregnancy test

    AAPC: Back to School
    I'm having trouble with a pregnancy test getting paid. I submitted an OV, an HCG Serum with a blood draw admin charge with a 626.0 code and I can't get it paid. Any suggestions? I called the Ins co and they were uncooperative in giving me any answers.

    I'm new to coding so if this has a "Duh" answer, I apologize.

  2. #2
    Join Date
    Apr 2007
    Columbia, MO


    If it is a pregnancy test to see if the patient is pregnant due to missed periods then 626.0 is the wrong code. That code is in the chapter for diseases and disorders of the genitourinary system and to have sex and think you are pregnant is absolutely normal. The definition of amenorrhea for 626.0 is an absences of menses for a period of 6 months or greater. So the code to for a patient that presents to the office due to a suspicion of pregnancy is V74.2x

    Debra A. Mitchell, MSPH, CPC-H

  3. #3


    Where do you get that the "definition of amenorrhea for 626.0 is an absences of menses for a period of 6 months or greater"?? The ICD-9 definition of 626.0 is "Absence of menstruation". I can't find any references that support the 6-month part. Need the reference, please!

  4. #4
    Join Date
    Apr 2007
    Columbia, MO


    look in a medical dictionary. Also my code book has this definition as a ppart of the code.. check Channel educational annotation code book.
    from a medical dictionary:
    amenorrhea occurs when a woman who has been having normal menstrual cycles stops getting her periods for 6 or more months
    Primary amenorrhea is when a girl has not yet started her monthly periods, and she:

    Has gone through other normal changes that occur during puberty, and
    Is older than 15

    Debra A. Mitchell, MSPH, CPC-H

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