More codes for families in trouble mean less worries for you.
Take advantage of new counseling codes to give a more specific picture of the patient's health status as influenced by family circumstances.
"The first thing coders are taught is not to use V codes as a primary diagnosis and for the most part that is true," says Karen K. Byrne, RN, BS, CPC, coding analyst forCarolina Health Specialists in Myrtle Beach, S.C. V codes, however, help present the entire picture of the patient and her visit.
Include Death and Absence in Family Disruption Codes
Two new codes allow you to justify why individuals who suffered from these family disruptions are seeking medical care or advice. New codes include:
• V61.07 -- Family disruption due to death of family member
• V61.08 -- Family disruption due to other extended absence of family member.
You would have previously described these family disruptions with the code for "Other family disruption" (V61.09).
Beware: These two codes can serve as either the primary diagnosis or as an additional code. This gives coders flexibility in using these codes.
Don't be too hasty, though; it is important to note that V61.07 may not be used when a patient is in bereavement (V62.82) and that V61.08 may not be used when the extended absence of the family member is due to military deployment (V61.01), advises Kris Cuddy, CPC, CIMC, of KC Medical Consulting Services in DeWitt, Mich.
Use Specific Code for Parent-Child Problem
Whereas parent-child problems previously were coded under V61.20 (Counseling for parent- child problem, unspecified), 2010's ICD-9-CM provide more specific codes that clearly establish the particular relationship between the parent and the child. These new codes are:
• V61.23 -- Counseling for parent-biological child problem
• V61.24 -- Counseling for parent-adopted child problem
• V61.25 -- Counseling for parent (guardian)-foster child problem.
These additions are particularly important, as they will provide added options for billing when encountering certain sensitive family circumstances.
Remember that counseling V codes are to be used when:
• a patient or a family member receives assistance in the aftermath of an illness or injury
• support is required in coping with family or social problems
• a child is brought to the office because the parents are concerned for his/her behavior
• the doctor sees both the parent(s) and the child because of the presence of problems in their relationship.
Add Addiction in Counseling Codes
When an individual seeks medical care or advice due to a family member with substance abuse, you can use this new code:
• V61.42 -- Substance abuse in family.
Previously, ICD-9 only listed alcoholism in family (V61.41). The addition of V61.42 recognizes the effect on the family if a member has a substance abuse problem.
Continue using V61.49 (Health problems withinfamily; other) for other specified health problems in a family, such as the care or presence of a sick or handicapped person. Similar to the other codes, this could stand as either a primary or an additional code.
