# Denial of 58563 dx abnormal uterine bleeding



## OBcoder2017 (Apr 30, 2013)

I have received a Denial from United Health Care for the 58563 with dx 626.9 (abnormal uterine bleeding) stating that "treatment has not been deemed proven to be effective by the payer".  Has anyone else experienced this yet? What should my recourse be in this case?  I have reviewed the op note and patient was  having irregular heavy painful menses, passing large clots.  I would appreciate any feedback, thanks.


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## melmason98 (Apr 30, 2013)

*Changing diagnosis*

Have you tried changing your diagnosis?  626.9 is an unspecified code.  With irregular and heavy menses, I use 626.2, menometrorrhagia.  I have not had any problems billing for a hysteroscopic ablation with this diagnosis.


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## Anastasia (May 12, 2013)

I agree with using diagnosis code 626.2. However we had a similar issue here in Pennsylvania with one of the insurance companies. It turns out that some of their plans denied the procedure  without pre-authorization. Have you called to investigate further?


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