Does Apple Health Cover Vasectomy?

by | Last updated on January 24, 2024

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What is sterilization? Sterilization is any medical or surgical procedure intended to render the client permanently incapable of reproducing. This includes vasectomies (CPT® code 55250), tubal ligations (CPT® codes 58600, 58605, 58611, 58615, 58670, and 58671), and hysteroscopic sterilizations (CPT® code 58565).

Does Washington Apple Health cover out of state?

Receipt of Medicaid Coverage in Another State


When a person moves to Washington and is currently receiving Medicaid from the other state, HCA will provide Apple Health coverage to the new Washington resident

. The person needs to contact the other state to report the move.

Does Medicaid cover vasectomy in Maryland?

The Maryland law, which took effect Jan. 1,

mandates that insurers cover vasectomies without requiring patients to pay anything out-of-pocket

— just as they must do for more than a dozen birth control methods for women.

How much is a vasectomy?

The cost of a vasectomy in the U.S. is

between $300 and $3,000

, making it less expensive than tubal ligation. This depends, though, on if and what type of insurance you may have and where the vasectomy is done. Be sure to check these details before moving forward with your decision.

Does a vasectomy hurt?


You may feel some discomfort or pain after your vasectomy, but you shouldn’t be in terrible pain

. You may also have some bruising and/or swelling for a few days. Wearing snug underwear that doesn’t let your testicles move too much, taking over-the-counter pain medication, and icing your genitals can help ease any pain.

What does CPT code 58661 mean?

DEFINITIONS: Procedure Code 58661 –

Endoscopic procedures fallopian tubes and/or ovaries with removal of adnexal structures (partial or total oophorectomy and/or salpingectomy)

.

What is the CPT code for a vasectomy?

Practices are advised to use

CPT 55250

Vasectomy, unilateral or bilateral (separate procedure), including postoperative semen examination(s).

What is the anesthesia code for a cholecystectomy?


47562 (laparoscopic cholecystectomy without cholangiography) 47563 (laparoscopic cholecystectomy with cholangiography) 47564 (laparoscopic cholecystectomy with exploration of the common bile duct)

What are the side effects of vasectomy?

  • Bleeding or a blood clot (hematoma) inside the scrotum.
  • Blood in your semen.
  • Bruising of your scrotum.
  • Infection of the surgery site.
  • Mild pain or discomfort.
  • Swelling.

Is no scalpel vasectomy better?

A 2014 review notes the benefits of a no-scalpel vasectomy include

almost 5 times fewer infections, hematomas (blood clots that cause swelling under the skin), and other problems

. It can also be done more quickly than a conventional vasectomy and requires no sutures to close up incisions.

Are vasectomies reversible?

Risks.

Almost all vasectomies can be reversed

. However, this doesn’t guarantee success in conceiving a child. Vasectomy reversal can be attempted even if several years have passed since the original vasectomy — but the longer it has been, the less likely it is that the reversal will work.

Is Apple Health the same as Molina?

Molina gives you extra benefits.

Basic Apple Health provides core medical services, including doctor visits, hospital stays, prescriptions, lab tests and x-rays and more. But

the Molina Apple Health plan doesn’t stop there

. It provides lots of extra benefits that give you even more ways to stay healthy and save money.

What are the income limits for Washington Apple Health?

Today, Apple Health covers adults with incomes

up to 138 percent of the federal poverty level

. In April 2022 that translated to about $18,754 for a single person or $38,295 for a family of four.

Who takes Washington Apple Health?

Washington Apple Health is health coverage for

low-income adults, children and families

. Eligibility is determined by things like age, family size and income. Enrollment is done through Washington Healthplanfinder, www.wahealthplanfinder.org.

Why you should not get a vasectomy?

Vasectomies can have some risks.

But all medical procedures have some possible risks. The most common risk with a vasectomy is infection, but those are usually minor and treatable with antibiotics. You may also have some pain, bleeding, bruising, or swelling after the procedure. Read more about vasectomy safety.

Does a vasectomy affect size?

When performed by our highly skilled doctors an open-ended vasectomy procedure should cause little to no scarring, and certainly

will not visibly change the size

or shape of your testicles.

How long are you fertile after vasectomy?

You’ll be able to have protected sex after the surgical site heals. This typically takes

one or two weeks

after the procedure. You’ll be able to have unprotected sex after a semen analysis shows that there isn’t any sperm left in your semen. This is usually around 3 months after the procedure.

Can ejaculating too soon after vasectomy damage it?

It’s not a serious condition, but it can cause pain and may need to be surgically removed. Other possible side effects of masturbating too soon after a vasectomy include:

pain lasting longer due to tissue irritation or damage

. soreness and bruising around your scrotum.

Does it feel the same after a vasectomy?

“You will not experience any differences in your sexual function or pleasure. You will still be able to have sex and ejaculate, and

everything will feel the same

.” And that is probably a relief to men and women everywhere.

Does it hurt to pee after a vasectomy?

These may include:

Pain or burning when you urinate

. A frequent need to urinate without being able to pass much urine.

Is CPT 58661 sterilization?


Salpingectomy (procedure code 58661 or 58700) is billed as a sterilization

but tubal ligation is listed as the specific type of operation (line 20).

What is the difference between CPT 58661 and 58670?

If the provider performed a laparoscopic salpingectomy for sterilization purposes, CPT code 58661 would be reported and not 58670. Other coding guidance resources have stated that

CPT code 58661 would be reported for a disease process and CPT code 58670 would be reported for sterilization

.

Does 58661 need a modifier?

There is a CPT Assistant article from Jan. 2002 that stated code 58661 was a unilateral procedure, so

modifier -50 should be appended when the procedure is performed bilaterally

.

What is Z30 09?

2022 ICD-10-CM Diagnosis Code Z30. 09:

Encounter for other general counseling and advice on contraception

.

How many RVU do you need for a vasectomy?

Procedures are also assigned RVU values. A joint injection might be worth three quarters of an RVU while a vasectomy is

11 RVUs

. These values are not affected by their reimbursements, and they cannot be amended by employers. They are meant to be representative of the work involved in providing that care.

When should I use Z30 2?

Code Classification

Z30. 2 is a billable diagnosis code used to specify a medical diagnosis of

encounter for sterilization

. The code Z30. 2 is valid during the fiscal year 2022 from October 01, 2021 through September 30, 2022 for the submission of HIPAA-covered transactions.

James Park
Author
James Park
Dr. James Park is a medical doctor and health expert with a focus on disease prevention and wellness. He has written several publications on nutrition and fitness, and has been featured in various health magazines. Dr. Park's evidence-based approach to health will help you make informed decisions about your well-being.