Insurance and diagnosis codes

Meritain in Kansas

I called to see if a procedure would be covered and while they said the procedure code looked to be covered the said no one could confirm whether or not the accompanying diagnosis code would cause any claim to be considered covered.

I understand they cannot say absolutely something is covered before processing a claim, but the rep said no one could look up icd9/diagnosis codes to see if it might be considered covered. I find this INCREDIBLY odd.

I did ask for a supervisor callback but does anyone have any insight? This is for infertility, btw, which my insurance does not cover but some of the tests they run MIGHT be covered based on accompanying diagnosis codes and I'm just trying to get some peace of mind.

I previously had this test done with another insurance (Aetna, which Meritain is a subsidiary of) also with no infertility treatment coverage and it was considered covered, which is why I'm just trying to verify with new insurance.

Tia!

submitted by /u/TimePatient7769
[comments]