Insurance denied hepatitis test req'd by RE--How to get it covered?

[lkmiscnet]

The hep test was part of all the bloodwork required by my fertility clinic before proceeding with our FET.

Apparently, it is not covered when coded under a diagnostic infertility code, as it does not cause infertility. Both my husband and I had to have the tests, which cost almost $500!

Anyone get that test covered and can you tell me how your clinic got it covered? What code did they use? I think the codes are universal. They should be able to re-code it and  re-submit it.

 

I'm guessing that if my regular primary care physician had ordered the hep test as part of a normal exam, it would have been covered, so not sure how a fertility clinic would need to code it. Maybe I would have needed to have shown "symptoms" to justify the test...

Thanks.

[cheerma]

I'm a wahm for an insurance company. Have your doc resubmit the claim with any dx you have that is the confirmed/possible underlying medical cause of your infertility. Many plans cover the cost to treat and test for the underlying medical reasons. They won't deny treatment that is medical. Maybe you have pain during menses or irregular cycles. Just any other medical dx should work. Even women who aren't ttc would want their pain or possible medical conditions treated. PM me if you need more info.