Community Conversation > Male to female transsexual talk (MTF)

Electrolysis CPT Code

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Artesia:
My Anthem Blue Cross auto declines it :(

Michelle_P:
I'm pretty sure most insurers auto-decline EVERYTHING. Did you know that the actual job title of the nice person that processes your claim is "loss mitigation specialist?"

With insurers it pays to develop a tough skin and immediately re-file a denied claim. There is a state agency for insurance companies that usually has a customer grievance or advocacy office (unless totally in the insurers pocket), and if the re-filed claim gets denied, file a complaint and snail mail a copy of the complaint and denied claim to the corporate VP running the
Medical Insurance unit. They often have a "make it go away" desk.

Always keep copies of the claims and rejections. I scan them into a computer and generate hard copies as needed. Each piece of correspondence gets all the older filings, letters and rejections attached to it for their convenience and a not so subtle reminder that you do have a record and are being diligent.

Oh, and be diligent about this.

Trust me, being obnoxiously persistent pays off. It's how I roll.


Sent from my iPhone using Tapatalk

Maybebaby56:

--- Quote from: sarahla on January 25, 2017, 09:26:55 am ---The CPT code, 17380, provided in this posts answer is correct.

The pre-authorization must also include 2 ICD (ICD-9-CM) codes

308.25 Gender role disorder
V.49.89 Transgender

Somehow through magic the insurance company will know that "electrolysis for transgender patients" means electrolysis for GCS/SRS.

Thanks! Now off to Blue Shield.

--- End quote ---

Thank you for this, Sarah. You prompted me to contact my insurer (Aetna) for the $$$ I have spent on genital electrolysis.

Small note:  The 2016 ICD-9-CM code for gender identity "disorder" is 302.85, not 308.25.  The 2017 ICD-10-CM code is now F64.0. The "V.49.89 Transgender" I couldn't find anywhere.  Can you help?


--- Quote from: Michelle_P on January 25, 2017, 05:34:32 pm ---I'm pretty sure most insurers auto-decline EVERYTHING. Did you know that the actual job title of the nice person that processes your claim is "loss mitigation specialist?"

With insurers it pays to develop a tough skin and immediately re-file a denied claim. There is a state agency for insurance companies that usually has a customer grievance or advocacy office (unless totally in the insurers pocket), and if the re-filed claim gets denied, file a complaint and snail mail a copy of the complaint and denied claim to the corporate VP running the Medical Insurance unit. They often have a "make it go away" desk.

Always keep copies of the claims and rejections. I scan them into a computer and generate hard copies as needed. Each piece of correspondence gets all the older filings, letters and rejections attached to it for their convenience and a not so subtle reminder that you do have a record and are being diligent.

Oh, and be diligent about this.

Trust me, being obnoxiously persistent pays off. It's how I roll.

--- End quote ---

Great advice, Michelle. You're a smart girl!

~Terri

sarahla:
Thank you.

(A slightly off topic, but is there a way to get notified of a response to a post that I either created or a reply to a post that I made on someone else's topic? Right now I have to come back to the page and refresh the page to see if any updates. That is a bit annoying.)

Dena:
Not sure this is the answer you are after but on the top left of the screen there is "Show new replies to your posts" which will tell you of threads you posted to that have been active after that. Unfortunately the box on the right takes you to the last post in the thread. You have to backup in the thread until you find your post then work your way forward. The recent topics list works differently in that the box on the right gives you unread posts.

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