Advanced Search

Ob-Gyn Coding Alert

Reader Questions:

Patient Fears Pregnancy? Not a Medical Condition

Published on Sat Jan 05, 2008

Question: I have a patient who wants a tubal ligation due to her phobia of getting pregnant. The doctor calls it cyesophobia or tocophobia. Either way, I cannot find a diagnosis code. What should I use?
Rhode Island Subscriber  Answer: The tubal ligation is still an elective procedure. The ob-gyn is not performing it for a medical condition (her fear is not a -medical- condition). Therefore, you-ll still use V25.2 (Encounter for contraceptive management; sterilization).  Optionally, you can assign a code from the mental health chapter (300.29, Other isolated or specific phobias), but the payer is not going to care one way or the other. If she has coverage for a tubal, they will pay; if not, they won-t, and she will have to pay for the procedure. It all comes down to coverage.
You’ve reached your limit of free articles. Already a subscriber? Log in.
Not a subscriber? Subscribe today to continue reading this article. Plus, you’ll get:
  • Simple explanations of current healthcare regulations and payer programs
  • Real-world reporting scenarios solved by our expert coders
  • Industry news, such as MAC and RAC activities, the OIG Work Plan, and CERT reports
  • Instant access to every article ever published in your eNewsletter
  • 6 annual AAPC-approved CEUs*
  • The latest updates for CPT®, ICD-10-CM, HCPCS Level II, NCCI edits, modifiers, compliance, technology, practice management, and more
*CEUs available with select eNewsletters.

Other Articles in this issue of

Ob-Gyn Coding Alert

View All