Wiki Coding for Vulvectomy

[bmills228@icloud.com]

We have been trying to bill a vulvectomy for a couple months now. It was denied by the patient's insurance and the reason on the EOB was because it was considered a cosmetic procedure.

After submitting a reconsideration for the claim with office notes it still is not being paid.

The patient contacted her insurance and they told her that we are not billing the procedure properly and that's why it is not being paid.

We billed 56620 with a dx of 624.3, and we cannot figure out another way to charge this.

Any suggestions would be greatly appreciated!!!!

Thanks,
Becca

 

[kvangoor]

Sounds like you are billing it properly. I would ask for a copy of the medical policy regarding this CPT. Some payers consider it cosmetic unless done for specific dx and that might be the reason for non payment. I hate when the insurance company tries to tell the patient we did not bill it properly!

 

[Anastasia]

I would also send a letter from the physician, documenting symptoms.