Our infertility practice in IL is having a hard time coding pts who are diagnostic. The patients have come in from an OB/GYN office having been treated w/ Clomid. I am hoping someone can help clarify or agree that once a patient starts meds to treat the disease(in this case infertility) they can no longer use code V26.21--fertility testing. Unfortunately the OB/GYN's have gotten into the practice of giving out Clomid but not performing the dx tests first. Insurances w/ dx policies only will not cover these tests under 628.9 or unspecified infertility. Hoping someone can help clarify the use of V26.21 in these circumstances.
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