Primary Care Coding Alert

To avoid denials for V72.3x, always add a "1" or a "2" to the code. Assign V72.31 or V72.32, Not V72.3 ICD-9 2005 revised gynecological examination code V72.3x (Special investigations and examinations; gynecological examination). The well woman exam code now requires a fifth-digit subclassification.

Problem: The April 2005 Family Practice Coding Alert reader question "No IPPE Equivalent Exists for Current Patients" listed V72.3 as the diagnosis to use with 99397 (Periodic comprehensive preventive medicine reevaluation and management of an individual ...). "But this code is truncated," Velina Ruffino says.

2005 method: "The choices now are v72.31 or V72.32," writes Donna Hensley, coder at Alder Medical Center in Brookings, Ore. The fifth-digit represents:
  V72.31 - Routine gynecological exam
  V72.32 - Encounter for Papanicolaou cervical smear to confirm findings of recent normal smear following initial abnormal smear. Solution: The Family Practice Coding Alert example describes a 65-year-old established patient on Medicare who presents for her annual well-woman check. The family physician also performs a screening Pap smear, a pelvic exam, a clinical breast check and ECG. The answer should have stated that you should link 99397 to V72.31 (Routine gynecological exam), not to V72.3 (Gynecological examination).