Anesthesia Coding Alert

Diagnosis Focus:

Apply This Real-Life Scenario to Use V Codes Effectively

Don't shy away when these codes can help your claimsIf you avoid ICD-9's V code section because you don't think it applies to your claims, think again. Check out the following example of when V codes can help your claims, courtesy of Emma LeGrand, CCP, CCS, coding supervisor for New Jersey Anesthesia/Health Network Management in Florham Park.Follow Subterms to the Best DiagnosisA patient with a high risk of breast cancer (because of a strong family history of breast cancer) is admitted for prophylactic organ removal of her breast. You have several main terms to choose from for diagnosis coding, so here's a step-by-step method to follow:1. Search for the term "Admission" in the ICD-9 index.2. Beneath the term "Admission," reference the subterm "for."3. Follow your choices to the subterm "prophylactic."4. Beneath "prophylactic," look for "organ removal."5. Under "organ removal," end at "breast," which designates code V50.41 (Prophylactic organ removal; breast).6. Look up V50.41 in ICD-9's tabular section to check for additional instructions or coding guidelines.The surgeon and anesthesiologist can each submit their claims with V50.41 as the primary diagnosis and V16.3 (Family history of malignant neoplasm; breast) as the secondary diagnosis."Coders do not have to restrict themselves from using V codes," LeGrand says. "V codes provide additional information and specificity, which helps your coding and helps get your claims paid."Caution: Carrier guidelines can differ in their use or acceptance of certain V codes, so check their policies before submitting claims.LeGrand also recommends periodically reviewing the ICD-9-CM Official Guidelines for Coding and Reporting, which you can download from http://www.CMS.hhs.gov/ICD9 ProviderDiagnosticCodes."It's always good to review the basics from time to time," she says.
You’ve reached your limit of free articles. Already a subscriber? Log in.
Not a subscriber? Subscribe today to continue reading this article. Plus, you’ll get:
  • Simple explanations of current healthcare regulations and payer programs
  • Real-world reporting scenarios solved by our expert coders
  • Industry news, such as MAC and RAC activities, the OIG Work Plan, and CERT reports
  • Instant access to every article ever published in Revenue Cycle Insider
  • 6 annual AAPC-approved CEUs
  • The latest updates for CPT®, ICD-10-CM, HCPCS Level II, NCCI edits, modifiers, compliance, technology, practice management, and more

Other Articles in this issue of

Anesthesia Coding Alert

View All