Daniel, Urodynamics is definitely not a component or related to D& C at all on any account.
No way. They cannot include/ couple it with D& C. Oh my God, the anatomy and the body systems have to be reviewed to refresh their validation in doing so.
But one thing I could say: Why they could have denied is because you placed a diagnosis vaginal prolapse and vaginal prolapse as such do not justify the medical necessity. you know the insurance try to cut short as much as possible for you.
Your doctor cannot change the diagnosis, since it is already done but at least can definitely use additional code to identify the stress incontinence. If your doctor can add or place stress incontinence or mixed incontinence as the additional diagnosis( 625.6,788.3 or applicable 788.3x series) for this urodynamic, you are definitely to get it payed.
Vaginal Prolapse can only be a causation for the incontinence, which in turn makes the medical necessity for performing urodynamics; this intricacy those insurance people
may not/try not to understand to validate. So we have to definitely mention the incontinence as the reason for doing the Urodynamic study.
More over, you can very well see in your guide notes in the ICD_9 that you have to identify additional diagnosis of URINARY INCONTINENCE( FROM 625.6, 788.31,788.33 788.39).
SO THEY HAVE REASON TO REJECT. Please try to clarify with your doctor and substantiate the point of importance of addendum of urinary incontinence as the main symptom and encounter for performing urodynamics study.
Without the urinary symptom of incontinence and its documentation , the performance of urodynamics would not be validated and you would not be paid.
I hope it makes some sense. Thank you Dan
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