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Originally Posted by KatCarney  Your doctor screwed up (big time) when s/he entered the code(s) for the tests. |
Correct. The need to change the diagnosis codes attached to the Office Visit and lab tests. They need to also make sure they didn't attach any "fertility" codes as additional diagnosis. Fertility diagnosis codes are 628._ _ (the blanks are for specifics of the disorder) and these should not be used unless you've had a fertility test and are ttc.
They can use 626. _ _ for disorders of mestruation, 704._ _ for Obesity, 704.1 for hirsutism and so on. The best people to talk to at the office is the billing and coding department. 256._ is PCOS diagnosis and should not be used unless every other possible diagnosis has been tested for.
The doctors office may need to file a corrected claim with medical records to back it up and it wouldn't hurt to do appeal and have all the information ready in case they deny it or it comes up in your insurance history later on.