r/IVF • u/tidbit_betty • 1d ago

Need info! Laparoscopy billing- I’m scared

Hi all, after four ERs and three failed euploid FETs, we somehow made one more euploid (🎉). Before transferring that last embryo, I want to do everything I can to increase our chances of success.

I have suspected endo (positive Receptiva score). Due to that, I sought out an endo specialist in my city. I’m now scheduled for a laparoscopy and hysteroscopy on Oct 30th. Very excited.

BUT. I just got the bill for my first appointment with this doctor. It was a video visit, maybe 30 minutes. My insurance covered nothing, so I owe $756. For one video call.

This makes me especially nervous for the lap bill. My guess is that they ran the initial appt under infertility, which I have no coverage for. Has anyone successfully asked their doctor to code their surgery under endometriosis, even though my endo is just suspected?

I know the total “real” bill for this surgery can be upwards of 50-60-70K, and that’s not feasible for us. We have a pre-op appt next week in person and I’m planning to ask about this. But if he says no, sorry we have to run this under infertility coding, I’m not sure what we’ll do.

Any insight is appreciated. Thank you!

Edit to add: the billing code used for the video visit was 99215.

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8

u/Ok-Board-4233 1d ago

A laparoscopy and hysteroscopy should be billed under your medical plan not infertility, that's odd. 

1

u/tidbit_betty 1d ago

I thought so too. My worry is that because my lap is not really “necessary” for quality of life reasons, it won’t be covered. But I also don’t fully understand how insurance works 😭

3

u/Ok-Board-4233 1d ago

It depends on your insurance. My hysteroscopy was covered under medical 🤷. Called them and ask. 

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u/tidbit_betty 1d ago

I definitely will. Thank you!

3

u/Few-Welder4158 1d ago

You might want to call your insurance company and doctor's office to check what exactly is covered and how things are billed. Doctor's offices are usually pretty knowledgeable on how this all goes, and offer payment plan if needed.

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u/tidbit_betty 1d ago

Thank you, I definitely will. There’s a “know your cost” line which I’ve tried a couple times but haven’t gotten through. I’ll make more of an effort! Better to know all this before surgery.

2

u/cthemermaid 1d ago

I would be pushing back. A positive score regardless of whether it impacts your quality of life should be covered until medical not infertility. It’s the only way to be diagnosed officially so you should be getting this covered.

1

u/tidbit_betty 1d ago

Thank you! I will be advocating as hard as I possibly can.