Anesthesia Coding Alert

Question: I'm coding for a laparoscopic tubal ligation with a diagnosis of "undesired fertility." We normally report V26.51, but the carrier denied it. We appealed with V25.2 and then V61.5, but the carrier denied both. Should I report another code in addition to the V code?


Arizona Subscriber


Answer: Many coders agree that V25.2 (Sterilization) is the correct code and should be accepted, although some coders have success with V61.5 (Multiparity) instead. Some carriers prefer anxiety-related diagnoses instead, such as 300.09 (Anxiety states; other).
 
The carrier might deny V26.51 (Tubal ligation status) because it considers this a code for checking the status of a previous sterilization procedure rather than the sterilization itself.

Also verify that you're reporting the correct anesthesia code for the procedure: 00851 (Anesthesia for intraperitoneal procedures in lower abdomen including laparoscopy; tubal ligation/transaction). Finally, check to see whether the carrier's policy has changed and appeal if necessary.

You Be the Coder and Reader Questions were reviewed by Terry Celestino, CPC, with Tejas Anesthesia in San Antonio.