Author Topic: Multiple Myomectomy and Chromotubation  (Read 537 times)

Tameka79

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Multiple Myomectomy and Chromotubation
« on: January 24, 2017, 01:38:26 PM »
Good Afternoon,

I was wondering if someone could help me. The Dr. did a multiple myomectomy and then did a chromotubation.  He is stating the dx for both is D25.1,(Intramural leiomyoma of uterus).  I do not think the insurance will pay for the chromotubation with this dx, however, I can not find a could that states patency of the fallopian tubes.  Also, I am not even sure if I can bill the chromtubation since he did it to make sure her tubes were still open after the myomectomy.  I can understand why he did it, but I am thinking that insurance companies may say that it was not necessary. 

Any suggestions or explanations would be greatly appreciated.

Michele

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Re: Multiple Myomectomy and Chromotubation
« Reply #1 on: January 25, 2017, 11:17:44 AM »
I am not a certified coder but I'm taking a stab at your question. 

Since the dr did the chromotubation due to the D25.1 that would be the correct code to use, whether or not it would be covered shouldn't be the reason the code is selected.  There does not appear to be a more appropriate dx.  Like you said, the insurance carriers may not consider the chromotubation medically necessary and it may not be a covered benefit.  So in my opinion you should bill for the chromotubation since it was done, with the D25.1 dx since that was ultimately the reason that it was done, but knowing that it may not be allowed.

I hope that this is helpful.  Sometimes just hearing someone else's logic helps.  :)
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Tameka79

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Re: Multiple Myomectomy and Chromotubation
« Reply #2 on: January 26, 2017, 02:48:32 PM »
Thank you Michelle and I agree with you.  I would have to use the D25.1, but I was wondering if there was a patency of tubes code that I could use because in actuality he did the chromotubation to check for patency after the surgery.

But since I don't think there is one, I would have to use the D25.1 code. 

It did help me even more hearing someone else say it. :-)

Thanks again! I am not a certified coder either, well not yet anyway, but somehow coding always becomes a part of my job.