ICD-10 N83.00 is officially defined as "Follicular cyst of ovary, unspecified side." code N83.00 is referenced in 2 tracked payer policy changes from Blue Cross & Blue Shield of Mississippi. For billers and coders, staying current on payer-specific coverage criteria, reimbursement rules, and prior-authorization requirements for code N83.00 is critical to clean claim submission. Each entry below links to the full policy analysis with effective dates and action steps.
CA-125 measurement may be considered medically necessary in patients with symptoms suggestive of ovarian cancer or with known ovarian cancer. It may also be considered medically necessary for individual patients with other gynecologic malignancies, such as endometrial cancer, in whom baseline CA-125 levels have been shown to be elevated. Measurement of CA-125 is considered investigational in asymptomatic patients as a screening technique for ovarian cancer.
Measurement of estrogen hormones is considered medically necessary to evaluate ovarian function in females with symptoms of hypoestrogenism or hyperestrogenism, to diagnose hyperestrogenism in symptomatic males, to monitor hormone replacement therapy in postmenopausal females, and to monitor antiestrogen therapy. Measurement of estrogen hormones is considered not medically necessary when performed for screening purposes in asymptomatic patients. The covered tests are total estradiol (CPT 82670), fractionated estrogens (CPT 82671), total estrogens (CPT 82672), estrone (CPT 82679), and free estradiol by direct measurement, such as equilibrium dialysis (CPT 82681).
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