# urine tests



## chasarmil (Mar 8, 2012)

I work for a pain management clinic and we do drug screens on our patients.  For Medicare we bill a G0434 with V58.69 as the diagnosis code.  Medicare is now telling us we need another diagnosis code besides the V58.69.  What do other office's use?  
We have no problem with our commerical carriers.

Thanks
Robin


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## billingchic#1 (Mar 8, 2012)

V58.69 is for an established patient. We use V71.09 for new patients.


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## chasarmil (Mar 9, 2012)

@billingchic#1... do you use another diagnosis code besides the V code?  We are being rejected on our established patients too because we need to add another code...but I'm not sure what code(s) to add?

Thanks


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## mhstrauss (Mar 9, 2012)

billingchic#1 said:


> V58.69 is for an established patient. We use V71.09 for new patients.



Not sure I would agree with this.  V71.09 is observation for a suspected mental condition, which doesn't really have anything to do with Pain Management Urine Drug Screens.
We use V58.69 (for both new and estab pts) along with their diagnosis for being seen...back pain, chronic pain, etc.  I've also seen others that use V58.83. Here's another thread on this topic that you may find helpful:

https://www.aapc.com/memberarea/forums/showthread.php?t=63715

Hope this helps!


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## dwaldman (Mar 11, 2012)

The first-listed diagnosis should be the  condition the patient is presenting with that doctor is providing prescription drug managment . Additional informational diagnosis such as certain V codes would be secondary when billing for encounters with urine drug screens or for a stand alone UDS.


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## mitchellde (Mar 11, 2012)

If it is a screening before you put the patient on medication then you use a screening V code not the V71, V71 is observation for a condition not found, for the procedure to be screening, the patient must be asymptomatic for the condition being screened, observation for a condition not found intimates that there was some presenting issue.  If the patient is already on pain treatment and this is a routine med check for compliance, then it is drug monitoring that is the reason for the encounter so you code for therapeutic drug monitoring, V58.83 followed by the V58.69, followed by the 338.2x code for the chronic pain.


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## billingchic#1 (Mar 12, 2012)

Usually we just append the V code (it has to be primary diagnosis if you are billing mulitple). We haven't had any problems. Are you billing with the QW modifier too?


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