Wiki Surgical Pathology diagnosis

[renesmartpro]

Need assistance with a billing question--Fallopian tube segments - Lumen identified - no significant pathological changes
What Diagnosis code would I use? V25.2 keeps getting denied by insurance carriers stating 'Diagnosis code not valid for benefit'

 

[bbooks]

Wish I could help. V25.2 is the code we use with no problems. My only thought is whether tubal ligation is a covered benefit to these patients. Hopefully you can get more details about the denials from the insurance carriers who are denying.

 

[bbooks]

One other thought - did you submit with 88302 (which is the correct CPT)? 88302 X 1 if both tubes submitted as one specimen, 88302 X 2 if submitted as separate specimens.

 

[renesmartpro]

We did submit with the 88302 * 2 the problem is that because the patient is electing for the sterilization, Medicaid or any Medicaid affiliiate will not pay for the pathology testing.