ICD and CPT Insurance Billing Codes

[jon]

I finally found some billing codes, on orpha.net, that are what insurance companies require to determine benefit coverage. Not good at deciphering what's what, but the billing person for the doctor would. If your trying to get preauthorization for a surgery or procedure these are a must have.

Unless you find a clinical trial on clinicaltrials.gov, a doctor, hospital or clinic isn't going to treat you if they're not going to get paid. They are not charities, unfortunately!

Although many hospitals are nonprofits and tend to be more affordable.

You need a diagnostic code and a procedure code. Sometimes doctors will need to retry getting authorization using different codes and/or synonyms for the description of the procedure or the diagnosis itself. PN has several synonyms. More than just those listed below.

https://www.orpha.net/en/disease/detail/60039

Synonym(s):
Alcock syndrome
Pudendal algia
Pudendal neuralgia
Pudendal neuralgia by pudendal nerve. entrapment
Pudendal neuropathic pain syndrome
Pudendal neuropathy
Pudendalgia

ICD-10: G57.8

ICD-11: GA34.0Y

UMLS: C1997249

MeSH: D060545

GARD: 10713

Chat GPT came up with:

"CPT codes for pudendal nerve decompression surgery and related procedures include:64999: Unlisted procedure, nervous system (This code is often used for procedures that do not have specific CPT codes.)"

64905: Neuroplasty and/or transposition; pudendal nerve at the Alcock canal.

64911: Neuroplasty and/or transposition; pudendal nerve.

And also:

M79.2 - Neuralgia and neuritis, unspecified

[Violet M]

Thanks, Jon. Great info!

[April]

Thanks, Jon!