Internal Medicine Coding Alert

Question: When the internist performs diabetes screenings for our Medicare patients, what ICD-9 code should I use to prove medical necessity? Our internist recently conducted a fasting blood glucose test, and I am tempted to report a V code as the primary diagnosis. Should I?

Arkansas Subscriber

Answer: Yes, you should. Although some V codes are secondary diagnosis codes, there are instances in which you must use a V code as primary. A diabetes screening is one of those instances.

On the claim, report the following:

• 82947 (Glucose; quantitative, blood [except reagent strip]) for the test.

• V77.1 (Special screening for diabetes mellitus) linked to 82947 to show the reason for the test.

Note: When testing for diabetes, your internist may also perform a post-glucose test (82950, Glucose; post-glucose dose [includes glucose]) or a glucose tolerance test (82951, ... tolerance test [GTT], three specimens [includes glucose]) instead of the fasting test.

No matter what diabetes screening your physician performs, always append V77.1 as the primary diagnosis.