posted
Hi, Ruth - Please read my previous post below yours. Since no code exists for Post Tubal Ligation Syndrome - and it is not a recognized diagnosis with insurance companies - it is not possible to be reimbursed for the surgery by submitting post-tubal syndrome. It would just be sent back as "no such diagnosis".
[ December 31, 2004, 09:25 PM: Message edited by: Gary S Berger MD ]
posted
Thank you all very much. I checked with BCBS GA with the ICD9 * CPT codes provided before I read about PTD, and had no luck. I just wondered if anyone had tried this avenue and succeeded. Wishing all of you the best of luck, the longest of tubes, and the happiest New Year!!!!
posted
Although we are aware that this is a legitimate set of symptoms, PTLS is not recognized by insurance companies as a diagnosis and there is no diagnosis code. Thus, there is no chance of filing for reimbursement with this condition as a code is required to file a claim.
[ December 31, 2004, 09:27 PM: Message edited by: Gary S Berger MD ]
posted
BCBS coverage can differ greatly from plan to plan as well as from state to state. Your best bet would be to contact them directly regarding your individual policy. Good luck!
posted
I don't think that most Doctor's will acknowledge that there is such a disorder. They like to call us all crazy instead! That way they can avoid lawsuits! Ah the wonderful world of women's reproductive health! I have BCBS through New York and they wouldn't pay for it, but it never hurts to ask! Good luck, and long tubes to you!!!
posted
I was wondering if anyone has had any luck with BCBS GA HMO paying for the surgery under the diagnosis of post tubal disorder? I just read about the diagnosis yesterday. I thought this might be an avenue to try, 'fertility' or lack there of always gets them off the hook. Heading to Chapel Hill on 01/23 either way and very excited and happy about it! :-) Good luck to all of you.
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