Clinical Policy 1E-3, Sterilization Procedures – Claim Denials

Tuesday, December 15, 2020

Claim Denials for Sterilization CPT Code 58661

NC Medicaid has received calls concerning claim denials that providers are receiving with Explanation of Benefits (EOB) 01610- FAMILY PLANNING PROCEDURE CODE REQUIRES FAMILY PLANNING DIAGNOSIS. Please correct amnd resubmit when billing the sterilization CPT procedure code below.

58661 - Laparoscopy, surgical; with removal of adnexal structures (partial or total oophorectomy and/or salpingectomy).

NCTracks is being updated to correct this issue. Providers may resubmit claims denied for EOB 01610 for dates of service on or after Aug. 15, 2020 for reprocessing. 

Contact

NCTracks Contact Center: 800-688-6696