Submitting female codes under a male patient in a donor cycle
We got a rejection from the clearinghouse for using a female diagnosis under a male patient. My previous manager stated that it has to be billed under the intended parent (IP) because the donor is not on the policy.
Our software vendor advised: "The first step is to confirm that it's supposed to be billed like this. At least one state BCBS is asking people to put the policy on the donor and submit the claim with the donor as the patient and a note in box 19 that they are an egg donor."
Is this correct? He also suggested we reach out to the payer to get something from them that we can forward to the clearinghouse but I am concerned that procuring something like that would be difficult.
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Reimbursement for donor egg
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