# How to bill???



## jamiemarie (Jul 21, 2010)

I had a patient that had a bartholins cyst removed, we are billing the post op visit and I normally would bill that 

prepaid OV - no charge
V58.49 dx

I also noticed _V58.76 - Aftercare following surgery of the genitourinary system, NEC- Conditions classifiable to 580-629_However the notes is what's got me stummped:
_Note: Codes from this subcategory should be used in conjunction with other aftercare codes to fully identify the reason for the aftercare encounter
Excludes: aftercare following organ transplant (V58.44), aftercare following surgery for neoplasm (V58.42) _

Would I then code V58.76 and 616.2? What other aftercare codes are they referring to? I am guessing it means to bill V58.49 and V58.76 to specify the site of surgery. Although V58.49 can be billed alone. Can someone please help as I searched all over for this and came up with nothing but what the ICD-9-CM states. 

Thanks


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## Kiana (Jul 21, 2010)

*V58.49 vs V58.76*

V58.49 is for after care following surgery that would be like changing or removin drains or other after care that does not have a classifiable condition.  Since you have a specific dx for the surgery of the underlying condition 616.2 then you would use your V58.76 as your primary code 2ndry would be the 616.2 and bill with your post op cpt 99024.   Hope this helps.


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## mitchellde (Jul 21, 2010)

You cannot code what no longer exisits the cyst was removed so it n o longer is there this is a followup encounter following surgery unless as you stated drains or dressing are attended to in which case it is aftercare first and a code for the attention to device or dressings.  This sounds like a V67.09.  You do not code the 616.2 anymore.


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## jamiemarie (Jul 22, 2010)

So my intial thought was correct just not V58.49 instead use V67.09. Sounds good, I did not think we could use 616.2 as it was removed, however I was confused by the note, which after reading again and again and then you explained the meaning of the note in more lamens terms under the DX forum it makes sense. 

I went with V67.09 instead of V58.76 primary and V58.49 secondary. Thanks a bunch for the insight.


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