# Sequence of Diagnosis Code(s)



## C Clark CPC CEDC (Mar 12, 2014)

Hello Group:
Was hoping someone could please help me with the sequencing of the following diagnosis code(s).

v68.1
380.4
530.81
401.9

The claim was submitted with the above mentioned diagnosis code(s); in that order.  The doctor documented in his chart note ; pt here for rx refills for 530.81,  401.9 also complaining of bloody ear discharge, cerumen removal was performed

My question is when there's a New condition; doesn't that trump the V68.1 code? Any and ALL input would be greatly appreciated!!


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## DHirshfield (Mar 15, 2014)

You are correct.  The 380.4 would be sequenced first.  I usually put V codes last but it probably is what your preference is.


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## mitchellde (Mar 15, 2014)

The V68 codes are first listed only allowed, read your guidelines to verify this.  There are several V codes that are only allowed as first listed, these are listed for you in the guidelines.  Also in ICD-10 CM there are several Z codes that may only used first listed.


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## Lizz B (Apr 7, 2014)

Debra, I agree with your explanation for the position of V68.1. I'm wondering if the refill would even be coded as a new problem required work up and treatment. Wouldn't the cerumen impaction and removal take priority with 380.4 being sequenced first and the 530.81 and 401.9 following?  Thank you in advance for your response to these questions; your help is always appreciated!


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