Wiki Preventive coding for Tubal Ligation

[ebethowen]

Anthem Blue Shield sent out a letter stating The Affordable Care Act requires them to cover "permanent surigical contraception" at 100%. We have always used V25.2 Sterilzation when performing a tubal ligation. Anthem states this is not the correct preventive code in order to get payment at 100%. They will not tell us what is correct. Does anyone know or have a suggestion on coding a tubal ligation any other way.

 

[karey]

You can try V25.9-multiparity but it is an unspecified code. You can have a patient call their Anthem plan and ask what the appropriate diagnoses would be in order to have a sterilization done. They have to tell the policy holder. I would also suggest finding out who your local Anthem representative is and ask them.

These are the only other ones that I know of. V26.51 is a status update so it shouldn't be coded unless the patient is having a tubal implant. V26.51

Tubal ligation status V25.9

Unspecified contraceptive management