Ob-Gyn Coding Alert

Learn when you can use V codes as primary diagnoses

The V codes are not only for providing supplemental information on your ob-gyn claims, and you could be facing denials or lower payments because you-re avoiding V codes. They are, in fact, key elements to correct coding practices.
 
Caution: -I really believe reporting V codes is underutilized, especially in the outpatient setting,- says Mary Mulholland, BSN, RN, CPC, a reimbursement analyst for the office of clinical documentation at the University of Pennsylvania's department of medicine in Philadelphia.

You don't have to be wary of using your V codes. Take this quiz and see how you score when it comes to V codes. Read These 7 Questions Question 1: True or False: You can use V codes as primary diagnosis codes.

Question 2: True or False: You should use V codes only to represent -history of- diagnoses.

Question 3: When the ob-gyn doesn't get to the patient in time to deliver the baby (she delivers in the emergency department) but does deliver the placenta (59414, Delivery of placenta [separate procedure]), you should report ________ because the emergency-department doctor will report 650 (Normal delivery), assuming there are no other issues complicating the delivery.

Question 4: When you-re doing a hepatitis screening test for a non-pregnant ob-gyn patient, you should report _______ in the absence of any symptoms.

Question 5: A patient comes in for enteritis, but the ob-gyn doesn't order an NST--instead he documents that the patient's enteritis was not complicating the pregnancy. In that case, you should report 558.9 (Other and unspecified noninfectious gastroenteritis and colitis) and ______.

Question 6: If a pregnant patient has been exposed to Parvo but you don't have the definitive test results back yet, you should use 648.9x (Other current conditions classifiable elsewhere) and ________ for the diagnoses codes.

Question 7: For a patient who has had a tubal ligation but has not made an attempt to have it reversed, the only diagnosis would be _______.

Next, compare your responses to these expert answers. Check Out These V Basics
 
Answer 1: True. If you-re surprised, take heart. Many coders mistakenly believe that V codes are only appropriate as secondary codes.

Reality: Contrary to what you might have been told in the past, you may--and, on occasion, should--report V codes as a primary diagnosis.

Tip: Certain versions of the ICD-9 manual indicate whether you may report a V code as a primary or secondary diagnosis code with the indicators -PDx- (primary) and -SDx- (secondary) next to the code descriptor. If the code has neither a -PDx- nor an -SDx- designation, you may use that V code as either a primary or secondary diagnosis code, according to ICD-9 instructions.

Note: Payers may be more likely to deny claims that [...]