Wiki IUD Removal Diagnosis

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CPalmer

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Whenever a pt is seen for IUD removal, we use V25.42, but ins co's usually won't pay because it is not cvrd or must be medically necessary. If medically nec'y, can I submit the 58301 with a problem dx (pain, bleeding) or must it always be V25.42? I guess I could appeal with chart notes showing V25.42 and leave the processing to the ins and bill the patient after a denial.
 
I would bill the problem quoted as reason for the denial as the primary dx with V25.42 as secondary if you feel you need to use it. If the patient simply wants it removed to seek pregnancy then you would have to bill the V25.42 Be sure to get a waiver if the insurance billing rules require it, like Medicare or Medicaid so you can bill the patient if its a non-covered service. Does this help?:
 
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