The following 87 ICD-10-PCS codes are intended for non-covered procedure codes sterilization. The procedure codes shown below are identified as non-covered procedures only when ICD-10-CM diagnosis code Z30.2 (Encounter for sterilization) is listed as the principal diagnosis or secondary diagnosis.
The following codes can be used when performing vasectomies: ICD-10 Diagnosis Codes Z30.9 Contraceptive management, unspecified Z30.8 Encounter for other contraceptive management (applicable to post-vasectomy sperm count) Z30.09 Encounter for other general counseling and advice on contraception Z30.2 Encounter for sterilization
(b) When some circumstance or problem is present which influences the person's health status but is not in itself a current illness or injury. Reimbursement claims with a date of service on or after October 1, 2015 require the use of ICD-10-CM codes.
A corresponding procedure code must accompany a Z code if a procedure is performed. Categories Z00-Z99 are provided for occasions when circumstances other than a disease, injury or external cause classifiable to categories A00 -Y89 are recorded as 'diagnoses' or 'problems'. This can arise in two main ways:
Encounter for sterilizationZ30. 2 Encounter for sterilization - ICD-10-CM Diagnosis Codes.
ICD-10-CM Code for Vasectomy status Z98. 52.
Z98. 52 is a billable/specific ICD-10-CM code that can be used to indicate a diagnosis for reimbursement purposes. The 2022 edition of ICD-10-CM Z98.
Sterilization means any medical procedure, treatment or operation for the sole purpose of rendering an individual permanently incapable of reproducing and not related to the repair of a damaged/dysfunctional body part.
Sterilization is any medical or surgical procedure intended to render the client permanently incapable of reproducing. This includes vasectomies (CPT® code 55250), tubal ligations (CPT® codes 58600, 58605, 58611, 58615, 58670, and 58671), and hysteroscopic sterilizations (CPT® code 58565).
Under the Medicare Program guidelines the coverage of sterilization is limited to necessary treatment of an illness or injury. An example of necessary treatment is the removal of a uterus or removal of diseased ovaries (bilateral oophorectomy) because of a tumor, or bilateral orchiectomy in the case of prostate cancer.
Vasectomy CPT Code 55250 describes the surgical procedure for male sterilisation, also called permanent contraception. CPT code 55250 is also designated as 'vasectomy' and is intended for protection against pregnancy permanently.
CPT® 58670, Under Laparoscopic Procedures on the Oviduct/Ovary.
There's a good chance you can get a tubal ligation for free (or at a reduced price) if you have health insurance. Because of the Affordable Care Act (aka Obamacare), most insurance plans must cover all methods of birth control with no cost to you, including some female sterilization procedures.
Although written informed consent is not needed for most reproductive health services, it should be obtained from men and women who undergo sterilization, since that involves surgery and is considered permanent.
The regulations prohibit sterilization of women younger than 21 years and of women with mental disabilities, require waiting periods between the time of consent and the sterilization procedure (currently, a 30-day waiting period), and require the use of a standardized consent form 22.
Salpingectomy (58661 or 58700) is billed as a sterilization but tubal ligation is listed as the specific type of operation on line 20 of the consent form.
Practices are advised to use CPT 55250 Vasectomy, unilateral or bilateral (separate procedure), including postoperative semen examination(s).
ICD-10 code N46. 9 for Male infertility, unspecified is a medical classification as listed by WHO under the range - Diseases of the genitourinary system .
VasectomyVasectomy CPT Code 55250 describes the surgical procedure for male sterilisation, also called permanent contraception. CPT code 55250 is also designated as 'vasectomy' and is intended for protection against pregnancy permanently.
CPT® 58670, Under Laparoscopic Procedures on the Oviduct/Ovary.
Z30.2 is a valid billable ICD-10 diagnosis code for Encounter for sterilization . It is found in the 2021 version of the ICD-10 Clinical Modification (CM) and can be used in all HIPAA-covered transactions from Oct 01, 2020 - Sep 30, 2021 .
Z30.2 is exempt from POA reporting ( Present On Admission).
DO NOT include the decimal point when electronically filing claims as it may be rejected. Some clearinghouses may remove it for you but to avoid having a rejected claim due to an invalid ICD-10 code, do not include the decimal point when submitting claims electronically. See also: Contraception, contraceptive.