# follow up xray



## lmlaprise (Dec 21, 2009)

For a medicare patient, what is the correct way to report a follow up chest xray.  FIrst xray was taken approximately 5 weeks ago and pt in for follow-up.   Do you code the underlying codition first and then the V code to report follow-up?


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## ~*Audra*~ (Dec 23, 2009)

I am not sure what is correct or not, but for our radiology reports, I try to avoid V codes as much as possible because all the insurances like to deny them. But if I have to use them, I try not to use them as primary. Sometimes you can't avoid it because there is nothing else. I know Medicare especially likes to deny V70.0 , V72.5 and I think it's V71.2. 

So personally if I was coding your report I would code the underlying condition first and then the V code second.


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## AuntJoyce (Dec 23, 2009)

*Follow-up x-ray*

I can give you a scenario that may shed a little light on your situation.

If a patient is sent for a chest x-ray say on November 1, 2009 and the impression is pneumonia and the treating physician says come back in 4 weeks and we will re-examine you and send you for a follow-up x-ray, the rule of thumb is that the patient, while in 4 weeks may clinically be "healed" and no longer have those clinical findings of penumonia, they are not radiologically free of the pneumonia until an x-ray is done.  So, when they present to the Radiology lab for that follow-up x-ray, for all intents and purposes, they continue to carry the diagnosis of pneumonia until that x-ray is read and the impression states negative/normal/no pneumonia (or however they choose to phrase it).

I hope this helps put it in perspective...coding, the ever changing (and frustrating) career!

Have a great holiday!

Joyce


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## lmlaprise (Dec 23, 2009)

Thanks a bunch Joyce.  That was a wonderful way to explain this.  I will remember this the next time this situation presents.

Happy Holidays.

Laura


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## AuntJoyce (Dec 23, 2009)

*Follow-up x-ray*

You are very welcome.  I am all for easy...when things get too technical, they often don't find a home in (what's left of) my brain...as I always say, slim pickins when it comes to my brain cells.

Take care 

Joyce


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## mmail (Jan 13, 2010)

its to late to sent a message for your posting on 12-23-09 to laura
But it was great !! I think the same way as you.  5 thumb up !!!!
Why you nickname is guru ???


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