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Ophthalmology and Optometry Coding Alert

Reader Question:

V-Codes Lead for Long-Term Drug Effects

Published on Fri Sep 19, 2003

Question: When monitoring for drug effects related to long-term drug therapy, do you code the V-code first or the disease? For instance, say we're following a patient who has Lupus who is being treated with a high-risk steroid. Should we code the drug treatment or systemic condition first?

Illinois subscriber Answer: According to ICD-9 guidelines, you should put the V code first. Code V58.69 (Follow-up, long term, high-risk [current] medication), or V67.51 (Follow-up, completed treatment, high-risk medication), depending on whether the patient is currently taking the drug or has finished the drug treatment. The secondary diagnosis will be the condition for which the patient is taking the long-term drug.
 
In spite of the ICD-9 guidelines, other carriers will want the disease first and then the V code, so keep track of your different insurance companies' policies to ensure your reimbursement.
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