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Follicle scan diagnosis

Susan Posted Tue 12th of June, 2018 16:58:36 PM
Is Z31.41 an appropriate code for patient coming in for follicle scans to time IUI? Insurance covers "testing to determine fertility", but not "creating a pregnancy". Is this actually considered testing, even though she will come in for multiple scans? Would Z31.89 be more appropriate? We want as much to be covered as possible but also want to code correctly. Any advice?
SuperCoder Answered Wed 13th of June, 2018 08:13:20 AM

As per the documentation, the patient is coming in for the follicle scan to time IUI (Intrauterine insemination). This seems to be more of an investigational testing; hence, the most appropriate ICD-10 code seems to be Z31.49 (Encounter for other procreative investigation and testing) for the above scenario.

 

Note: Some payers may require the primary diagnosis along with the encounter code (Z- code) as secondary code.

So, in that case you may choose the appropriate primary diagnosis from the suggested code range: (N97.0 - N97.9)

 

I hope this helps.

 

Thank you.

Susan Posted Wed 13th of June, 2018 16:32:01 PM
Thank you that helps.
SuperCoder Answered Thu 14th of June, 2018 00:42:22 AM

Thank you. Happy to help!

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