Wiki infertility and PCOS

[swiedner7]

When seeing a patient diagnosed with PCOS for infertility treatment is the correct dx PCOS or infertility. AS PCOS is covered and infertility is most likely not covered we have conflicting opinions. I think even though the patient may have pcos we are not actually treating it, we are trying to get her pregnant. Dr thinks otherwise. How does anyone else bill these visits?

 

[CodingKing]

If treatment is directed to infertility, that would be the primary diagnosis. The fact the patient has PCOS affects treatment its a co-existing condition then it can be used as a secondary dx. Your provider is not directly treating the underlying condition but the side effect that came from it.

ICD-10 coding guideline IV.G

List first the ICD-10-CM code for the diagnosis, condition, problem, or other reason for encounter/visit shown in the medical record to be chiefly responsible for the services provided. List additional codes that describe any coexisting conditions. In some cases the first-listed diagnosis may be a symptom when a diagnosis has not been established (confirmed) by the physician.