Question: I have been listing the V57.x (Care involving use of rehabilitation procedures) codes only as principal diagnoses, but a colleague says she was told these codes could once again be listed as secondary. What's the latest word on this code category? -- Kansas Subscriber Answer: A footnote added to the V Code Table in the last update of the Official Coding Guidelines stirred up the home care coding community. That footnote effectively means that if more than one V code meets the definition of primary diagnosis, you can choose to code the second V code as a secondary diagnosis. What does this mean for V57.x? Keep in mind that this new footnote wasn't specifically directed to the V57.x codes, but it does mean that if therapy is one of the primary reasons for home care, you can list it in M0240. But why would you want to code V57.x as secondary? The V57.x code lends very little information and doesn't provide you with risk adjustment or payment. Medicare has warned about the overuse of V codes, especially V57.x, so it's best to try not to use this code too frequently. Unless otherwise indicated, reader questions were answered by Lisa Selman-Holman, JD, BSN, RN, HCS-D, COS-C, consultant and principal of Selman-Holman & Associates in Denton, TX.