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Ob-Gyn Coding Alert

Hold On to Initial Infertility Visit Dollars With This 2-Part Strategy

Published on Wed Sep 16, 2009

Symptoms, not infertility, may help your initial visit claim pass muster. Don't settle for infertility visit denials when a patient presents to your practice complaining she is unable to get pregnant. Focusing on symptoms rather than 628.9 (Infertility, female; of unspecified origin) can make all the difference in how payers view your claims. Get to the Crux of the Problem Most insurance carriers will not reimburse for infertility treatments, and many payers balk when the word "infertility" pops up. "Infertility services always require intensive review prior to a patient's visit," says Cheryl Ortenzi, CPC, billing and compliance manager of BUOB/Gyn in Boston. "In most cases, coverage is very specific. You have to verify coverage or lack thereof and review that with the patient so that everyone understands who is paying for these services." Maximize ethical reimbursement by following two guidelines: Step 1: Stick to the Presenting Symptoms "Generally, the initial [...]
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