Pediatric Coding Alert

Question: We performed a Hep B Surface Ab and a Varicella-Zoster Ab, IgG on a foreign-born adopted child to determine whether the patient had a previous vaccination. Which diagnosis codes can we use to bill these visits?

Indiana Subscriber

Answer: In this situation, you would use V codes to tell the insurer why you performed the testing. The following codes may apply to your situation, depending on the documentation:

• V15.83 -- Personal history of underimmunization status
• V01.79 -- Contact with or exposure to other viral diseases
• V01.71 -- Contact with or exposure to varicella
• V05.3 -- Need for other prophylactic vaccination and inoculation against a single disease; viral hepatitis
• V05.4 -- Need for other prophylactic vaccinationand inoculation against a single disease; varicella

The facts: The ICD-9 manual lists V codes under the category heading "Supplementary Classification of Factors Influencing Health Status and Contact with Health Services." This means that V codes often describe chronic conditions or underlying circumstances that might affect a patient's current health status or treatment.

How does this help you? Sometimes the V code will provide just enough information to turn a denial into appropriate -- or even extra -- reimbursement.

Certain codes in ICD-9 can only be used as secondary diagnosis codes, such as "E" codes, which are the diagnosis codes that HCPCS has designated to indicate the external cause of injury and are used with injury and poisoning codes to provide information about how the injury occurred, the intent (whether accidental or intentional), and the place where the incident took place.