|Tubal Reversal (Anastomosis)
Notes on Insurance Coverage
Insurance policies do not usually cover tubal surgery.
They may cover some of the evaluation or testing before
surgery without covering the surgery.
First check exclusions for
1) Infertility testing
2) Infertility services and treatment
3) Reversal of tubal ligation / tubal reanastomosis.
Then, if services are not excluded, ask if they cover
1) Infertility testing ICD-10 code Z31.41
2) Tubal infertility ICD-10 code Z97.1
3) Past tubal ligation ICD-10 code Z98.51
4) Tubal reversal CPT-4 code 58750
If you get an approval letter, read it carefully for
Insurance company approval does not always mean the
service is covered. The claim for an approved service
can be denied if the service was excluded or otherwise
not covered. Check for both exclusions and coverage.
The old codes were:
1) Infertility testing ICD-9 code V26.21
2) Tubal infertility ICD-9 code 628.2
3) Tubal reversal CPT-4 code 58750