# Dx.for routine venipuncture?



## veloso (Nov 16, 2010)

Hi to All,
  I just query a physician and told me that they have a hard time figuring out as to what is the RIGHT DX. if the patient came for a sick visit (ex.sore throat) and without any chronic illnesses and would like to have a routine venipuncture? and told me to keep the V70.0 as the DX for 36415.
  I know that V70.0 is okey if the encounter is Preventive Visit but since it's NOT maybe I'll use the V72.60? or V72.69? 
 I'm very confused ......needs HELP..

Thanks a lot!!1


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## kewing (Nov 16, 2010)

veloso said:


> Hi to All,
> I just query a physician and told me that they have a hard time figuring out as to what is the RIGHT DX. if the patient came for a sick visit (ex.sore throat) and without any chronic illnesses and would like to have a routine venipuncture? and told me to keep the V70.0 as the DX for 36415.
> I know that V70.0 is okey if the encounter is Preventive Visit but since it's NOT maybe I'll use the V72.60? or V72.69?
> I'm very confused ......needs HELP..
> ...


Why is the provider ordering the lab work?  If it is problem-related, then you would use the problem dx as the reason for the blood draw.  If the labs are for screening, then I would go into the V75 and beyond codes.  It has been my experience that payors do not like the V72.6x codes, especially as first-listed diagnoses.  If someone comes in for e.g. a sore throat and wants to have labs drawn to find out if they have e.g. thyroid problems as long as they are there, the reason for the venipuncture would then be V77.0 _Special screening for endocrine, nutritional, metabolic, and immunity disorders--Thyroid disorders._  If any symptoms are reported, those can be coded as well to support the testing.


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## veloso (Nov 16, 2010)

Thanks Keynard,
  Yes,for some encounters it was resolved beacuse I told them that if the patient has chronic illnesses like HTN and DM the provider did agree to linked the venipuncture BUT only for this example that he wants to keep the V70.0 BUT I'll to QUERY  the provider again if there's a particular screening that he would like to do..

Once again thank you very much for your INPUT..


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## preserene (Nov 16, 2010)

Ex Sore throat you said . Sore throat the first and most commonest and the dreaded infection the doctors think of is   Streptococcal infection - it can be for ASO titer or any other bacterial infection they could ask for. 
Since the type of suspected infection is not documented nor diagnosed, the encounter is for GME, you can code *70.0 *as the PRIMARY DIAGNOSIS, WITH THE USE OF ADDITIONAL DIAGNOSIS CODE* V75.9* UNSPECIFIED INFECTIOUS DISEASES, for the procedure of *36415  
*


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## veloso (Nov 17, 2010)

Hi Preserene,
   This the actual TESTS that are being ordered if you have any IDEA as to what specific V CODES that could be linked please and thanks.
2.V70.0=ROUTINE MEDICAL EXAM
Lab:COMP METAB PANEL W/EGFR Result Status : F ALT 16 6-40 - U/L N 
ALBUMIN 4.5 3.6-5.1 - g/dL N 
A/G RATIO 1.4 1.0-2.1 - N 
AST 20 10-30 - U/L N 
BILIRUBIN,TOTAL 0.4 0.2-1.2 - mg/dL N 
CALCIUM 9.5 8.6-10.2 - mg/dL N 
CARBON DIOXIDE 22 21-33 - mmol/L N 
CHLORIDE 104 98-110 - mmol/L N 
CREATININE 0.74 0.57-1.03 - mg/dL N 
GLOBULIN,CALCULATED 3.3 2.2-3.9 - g/dL N 
POTASSIUM 4.2 3.5-5.3 - mmol/L N 
PROTEIN,TOTAL 7.8 6.2-8.3 - g/dL N 
SODIUM 137 135-146 - mmol/L N 
EGFR NON AFR AMERICAN >60 >=60 - mL/min/1.73m2 N 
EGFR AFRICAN AMERICAN >60 >=60 - mL/min/1.73m2 N 
GLUCOSE 87 65-139 - mg/dL N 
UREA NITROGEN 8 7-25 - mg/dL N 
BUN/CREATININE RATIO NOTE 6-22 - N 
ALKALINE PHOSPHATASE 48 33-115 - U/L N 
Lab:LIPID PANEL Result Status : F HDL CHOLESTEROL 59 >=46 - mg/dL N 
CHOLESTEROL,TOTAL 215 125-200 - mg/dL H 
TRIGLYCERIDES 75 <150 - mg/dL N 
LDL CHOL, CALCULATED 141 <130 - mg/dL H 
CHOLESTEROL/HDL RATIO 3.6 < = 5.0 - N 
Lab: CBC (INCLUDES DIFF/PLT) Result Status : F DIFFERENTIAL An instrument differential was performed. - N 
HEMATOCRIT 37.9 35.0-45.0 - % N 
MONOCYTES,% 3.4 0-13 - % N 
WBC 7.4 3.8-10.8 - Thous/mcL N 
BASOPHILS,ABSOLUTE 22 0-200 - Cells/mcL N 
BASOPHILS,% 0.3 0-2 - % N 
EOSINOPHILS,ABSOLUTE 126 15-550 - Cells/mcL N 
EOSINOPHILS,% 1.7 0-8 - % N 
HEMOGLOBIN 12.8 11.7-15.5 - g/dL N 
LYMPHOCYTES,ABSOLUTE 2316 850-3900 - Cells/mcL N 
TOTAL LYMPHOCYTES,% 31.3 15-49 - % N 
MONOCYTES,ABSOLUTE 252 200-950 - Cells/mcL N 
NEUTROPHILS,ABSOLUTE 4684 1500-7800 - Cells/mcL N 
TOTAL NEUTROPHILS,% 63.3 38-80 - % N 
MPV 9.4 7.5-11.5 - fL N 
PLATELET COUNT 222 140-400 - Thous/mcL N 
MCH 27.9 27.0-33.0 - pg N 
MCHC 33.8 32.0-36.0 - g/dL N 
MCV 82.4 80.0-100.0 - fL N 
RDW 13.8 11.0-15.0 - % N 
RBC 4.60 3.80-5.10 - Mill/mcL N


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