Wiki V49.81 for Male

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buuvaneisswaran

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Hi all,

Can we use V49.81 for procedure 77080 for male.The code V49.81 states female diagnosis?:confused::confused:

Is there specific rule or documents supporting or declining this !!!
 
What are you trying to code?? V49.81 is a code for post menopausal status which can never be a male diagnosis, so yes it is correct that it can be female only.
 
V49.81

Yes i too agree, but when searching for supporting document i couldn't find it in web.I went through document in LCD coverage for 77080.It doesn't have this specificity for male diagnosis.
 

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It does not need to specify that it is not to be used as a male dx code since the description of the code itself is a female only diagnosis. A man cannot have post menopausal status ever. Why are you trying to use this code for a male patient? what is the reason the provider documented as the reason for the test. Just because a dx code is listed in the LCD does not mean it can be used in all instances.
Why are you needing anything else to support that this code is female only?
 
V49.81

Yes it was documented as indication for procedure 77080.I didnt had idea to proceed with V49.81.But i was confused why it was documented.On a search, most of procedure do had this indication beside its a male patient.Also in ICD 10, Z78.0 states the same(ie) Female diagnosis.So i was intend to get discussed in our forum.

Thank you so much mitchellde.Do you ever met this scenerio.Had rejections from payers side??
 
I would discuss this with the provider. Your claim will never pass the gender edits with this combination. It is not possible for a male patient to have this diagnosis. Can you post the provider note where it is stated that this is the patient dx and thus the reason for the study. If your patient is transgender then this could be the problem. I
 
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