Ob-Gyn Coding Alert

Warning: Do not report HIV codes unless it's confirmed

If your ob-gyn practice sees a patient with suspected HIV or asymptomatic or symptomatic HIV infection status, don't be caught scratching your head as to what diagnosis code you should report.

Take this quiz and find out where you stand when it comes to HIV coding proficiency.

Scenario 1: A patient presents to your ob-gyn office to determine whether she has HIV. You should report:

A. V08
B. 042
C. V73.89, V69.2
D. V65.44, 99401-99404
E. V65.44, 99241-99245

Answer: C. For your diagnosis code, you should use V73.89 (Screening for other specified viral diseases), says Laureen Jandroep, OTR, CPC, CCS-P, CPC-H, CCS, CPC-EMS, CEO of the Coding & Reimbursement Network Inc., an online coding certification training center based in Absecon, N.J. You may also use V69.2 (High-risk sexual behavior) as a secondary code if an asymptomatic patient is in a known high-risk group for HIV.

Remember: You should code only confirmed cases of HIV infection/illness. When your ob-gyn's documentation is unclear, you should ask your ob-gyn for clarification. A patient can have her records erroneously flagged by her  health or life insurance carrier if you report these diagnosis codes incorrectly, says Marvel Hammer, RN, CPC, CCS-P, ACS-PM, CHCO, owner of MJH Consulting in Denver. -It's always better to ask than assume if you-re unsure.-

Scenario 2: The patient returns for her HIV results, which are negative, and your ob-gyn counsels her. You should report:

A. V08
B. 042
C. V73.89, V69.2
D. V65.44, 99401-99404
E. V65.44, 99241-99245

Answer: D. You should use the diagnosis V65.44 (Human immunodeficiency virus [HIV] counseling). In this circumstance, you should also use the preventive medicine individual counseling codes 99401-99404, says Pat Larabee, CPC, CCP, coding specialist at InterMed in South Portland, Maine. -Remember, counseling is not a consultation.-

Note: If the results are positive but the patient is asymptomatic, you can use V08 (Asymptomatic human immunodeficiency virus [HIV] infection status). If the patient is both HIV positive and symptomatic, you should use 042 (Human immunodeficiency virus [HIV] disease).

Scenario 3: A patient with a symptomatic HIV infection status presents to your ob-gyn during her pregnancy.

You should report:

A. 647.6x, V08
B. 647.6x, 042
C. V73.89, V69.2
D. V65.44, 99401-99404
E. V65.44, 99241-99245

Answer: B. According to the ICD-9-CM Official Guidelines for Coding and Reporting, you should use 647.6x (Other specified infectious and parasitic diseases in the mother classifiable elsewhere, but complicating pregnancy, childbirth or the puerperium), followed by 042 and the code(s) for any related HIV illness(es), Jandroep says.

Heads up: If the mother is asymptomatic, you would use 647.6x along with V08.