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.