Pediatric Coding Alert

Question: An insurance company denied our claim for a lead test because we submitted a V code as the diagnosis. What's the correct diagnosis?Vermont SubscriberAnswer: A V code should be acceptable, but the situation will determine the best choice.Option 1: If the child has anemia associated with lead exposure, submit 285.9 (Anemia, unspecified). Report V15.86 (Contact with and [suspected] exposure to lead) for other signs associated with exposure. V15.86 is a secondary diagnosis code, so the payer might be denying your claim if you submit V15.86 alone.Option 2: For screening without underlying factors, submit V82.5 (Special screening for other conditions; chemical poisoning and other conditions). Include any documentation explaining the test's necessity. ption 3: Most insurance companies pay for lead screenings associated with V20.2 (Routine infant or child health check). Consider appealing to the insurer with a copy of the most recent guidelines for when to check for lead exposure. [...]