Medical Billing Forum

General Category => General Questions => Topic started by: ckadavid124 on November 24, 2011, 10:11:56 PM

Title: non-routine IUD re-check code? (OBGYN)
Post by: ckadavid124 on November 24, 2011, 10:11:56 PM
I had an IUD placed by my OBGYN. A follow up ultrasound was required a month later for an "IUD recheck", to make sure the IUD was properly placed. On my explanation of benefits it shows the Type of Service and Service code is : "Ultrasound Procedure" 76830. I called my insurance company and they said that the plan will not cover it because a routine code was used for a non-routine procedure, and to call my Doctor/billing and ask them to put a non-routine code in order for the insurance to cover this. I called my doctor they said that there was no other code they could use for an "IUD re-check". Is there such a "non-routine" code?

I appreciate your help immensely, I feel stuck.

Title: Re: non-routine IUD re-check code? (OBGYN)
Post by: PMRNC on November 26, 2011, 09:14:52 PM
76830 is the "procedure" code. it sounds like it's the diagnosis code that you need changed? First, the insurance company most likely did not tell you to have physician "change" the code, they can't do that, it's illegal. They are not even supposed to give coding advice. This is between the doctor and the documentation he/she has for the visit. If your plan does not cover the procedure for that diagnosis, the doctor cannot arbitrarily change the code to have it paid for. the 76830 is for a trans vaginal ultrasound which sounds right, so again, I'm guessing the problem is with their "diagnosis code"  They also might be denying it as being included with the placement?  Not sure but if you could read the exact denial from your EOB that might help us.
Title: Re: non-routine IUD re-check code? (OBGYN)
Post by: Michele on November 28, 2011, 06:36:08 PM
Everything Linda said is what I think as well, but I'm wondering.....isn't the ultrasound to check the placement part of the original service to insert the IUD?  Just curious, as a patient I would have thought it was part of the insertion to make sure it is in place correctly.