Ob-Gyn Coding Alert
Patient Fears Pregnancy? Not a Medical Condition
Question: I have a patient who wants a tubal ligation due to a phobia of getting pregnant. The doctor calls it cyesophobia or tocophobia. Either way, I cannot find a diagnosis code. What should I use? New York Subscriber Answer: The tubal ligation is still an elective procedure. The ob-gyn is not performing it for a medical condition, because her fear does not qualify. Therefore, you’ll still use Z30.2 (Encounter for sterilization). Optionally, you can assign a code from the mental health chapter (F40.248, Other situational type phobia), but the payer is not going to care one way or the other. If the patient has coverage for a tubal, they will pay; if not, they won’t, and the patient will have to pay for the procedure. It all comes down to coverage.
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