Pathology/Lab Coding Alert

Question: A physician client submits V70.0 as the ordering diagnosis for lab work. The lab receives denials for the lab tests. How can we avoid this problem?

Texas Subscriber

Answer: You’ll need to educate physician clients, because as the lab, you cannot change the ordering diagnosis.

Problem: You’re getting denials because of the ordering diagnosis V70.0 (Routine general medical examination at a health care facility). That may be the diagnosis the physician can use for the patient’s visit, but it won’t do for the ordered lab work.

Solution: Instead, the physician should request routine lab work from a routine exam using V72.62 (Laboratory examination ordered as part of a routine general medical examination).

You can educate physician clients about these codes, and /or design lab requisition forms to provide this sort of option.

Remember: For lab tests ordered for specific signs and symptoms or known conditions, your physicians should assign a specific ICD-9 code rather than using V72.62.