Vasectomy and Post Semen Analysis -- billing

[Guest guest]

For those doing vasectomies -- how do you handle the billing of the post vasectomy semen analysis?

1. Don't recommend them

2. Do them -- look at the sample myself in the office

3. Done through the local lab -- but cost absorbed into vasectomy fee

4. Done through the local lab -- but cost billed to the patient's insurance

My understanding is -- the semen analysis is part of the CPT 55250.

http://www.aafp.org/fpm/20031100/coding.html

In the July/August issue, " CPT code for semen analysis " [page 26] indicated that CPT code 89321 should be used for semen analysis post-vasectomy. This is true as long as the vasectomy and semen analysis were not performed by the same entity (e.g., if a family practice office lab does a semen analysis for a patient who received a vasectomy from a urologist across town). When the two services are performed by the same entity, the more appropriate code to use is 55250, " Vasectomy, unilateral or bilateral (separate procedure), including postoperative semen examination(s). "

The problem I am running into is -- I have been including the semen analysis in the total cost -- and this worked fine when the local lab tech could read them.

But that tech went away and the patients have to go through the hospital now.

The quirk is -- we charge for labs in our office, but the lab in our building is the hospital lab -- who charges us and we charge the patient.

But when the patient goes to the hospital, they screw it up and charge the patient -- so there is lots of monkeying around.

I guess the simple answer is -- since I'm not doing the analysis myself, I should just have them charge it to their insurance.

I was trying to save the patient a little money on the tail end.

For a 89321 Post-Vasectomy Semen Analysis -- the hospital charges the patient/insurance ~$65 -- and charges my office $6.50.

But I guess I should just say from now on -- you do the PVSA through the hospital and get charged through them.

Still curious what other vasectomists are doing.

Locke, MD