Pediatric Coding Alert

Reader Questions:

Use Screening, Not Vaccine Dx With TB Test

Question: We are trying to link the purified protein derivative (PPD) tuberculosis test to the correct ICD-9 code. We have been using V03.2 , but we think that diagnosis is incorrect because V03.2 is a vaccination code. Which ICD-9 code should we report?


Texas Subscriber
Answer: You should instead use V74.1 (Special screening examination for bacterial and spirochetal diseases; pulmonary tuberculosis) with 86580 (Skin test; tuberculosis, intradermal). When a nurse or other individual administers a PPD TB test, she gives the child an inoculation screening test, not a vaccination.

The TB screening test detects the disease's presence by inoculating the skin with the TB antigen. It doesn't vaccinate the child. A vaccination uses an inoculation to confer disease immunity. Therefore, you should link the test code to the special screening V code instead of to the vaccination code.

In fact, you will probably never use V03.2 (Need for prophylactic vaccination and inoculation against bacterial diseases; tuberculosis [BCG]). The World Health Organization doesn't recommend that United States physicians administer the BCG vaccine. The inoculation isn't very effective and interferes with skin test screening. People who receive a TB vaccination can give a false-positive when screened for the disease.
You’ve reached your limit of free articles. Already a subscriber? Log in.
Not a subscriber? Subscribe today to continue reading this article. Plus, you’ll get:
  • Simple explanations of current healthcare regulations and payer programs
  • Real-world reporting scenarios solved by our expert coders
  • Industry news, such as MAC and RAC activities, the OIG Work Plan, and CERT reports
  • Instant access to every article ever published in Revenue Cycle Insider
  • 6 annual AAPC-approved CEUs
  • The latest updates for CPT®, ICD-10-CM, HCPCS Level II, NCCI edits, modifiers, compliance, technology, practice management, and more

Other Articles in this issue of

Pediatric Coding Alert

View All