# E codes and V22.2



## jlv1980 (Apr 2, 2011)

Need help as I haven't had one of these in a long time. OB pt presents for exam and NST outside of the global package because she was in a car accident the day before (rear ended).  NST was fine.  How do the use the dx codes?  We normally follow her as an OB pt with history of infert V23.0.  Should I code V23.0,the E code and then the V22.2?  I'm needing to show this visit is outside of the routine global visits and there will be an e/m charge and also the NST.  I'm confused because the Ecode and the V22.2 should not be a primary code, correct? Thanks in advance!


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## Deb2009 (Apr 3, 2011)

First, did the physician document that patient's pregnancy is incidental to the encounter?

If so, you would code the reason for the encounter, the E code and lastly the V22.2

If the physician does not make the statement about the pregnancy being incidental, then the codes are: 648.93, reason for the encounter, the E code.  The V22.2 would not be coded.


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## MJ4ever (Apr 3, 2011)

*Dx priority*

Hi jlv 1980

You are correct. E codes and dx code V22.2 are always secondary codes.

Another thing I wanted to mention about 'incidental'. If the provider feels that the current complication is not affecting the outcome of the pregnancy, then he would have to actually make this statement in the note in order to code V22.2.

The coding order is correct that was given by the other coder.

Incidental:
1 dx or sign and symptom
2 E- code
3 V22.2 if the provider states that this visit is incidental to the pregnancy
E&M
NST

Without providers statement not being incidental
1 dx or sign and symptom (eg. abdominal pain 646.83 789.0x )
2 E-code (check for specific code if she was driving or not)
E&M
NST

Hope the pt & baby are ok.

Barbara


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## jlv1980 (Apr 5, 2011)

Thank you so much ladies!  I appreciate the help!


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