Primary Care Coding Alert

Question: When the FP performs diabetes screenings for our patients, which ICD-9 code should I use to prove medical necessity? Our physician recently conducted a fasting blood glucose test, and I am tempted to report a V code as the primary diagnosis. Should I?

Arkansas Subscriber

Answer: Yes. Though some V codes are secondary diagnoses, there are times in which you must use a V code as primary. A diabetes screening is one of those instances.

On the claim, report the following:

- 82947 (Glucose; quantitative, blood [except reagent strip]) for the test.

- V77.1 (Special screening for endocrine, nutritional, metabolic, and immunity disorders; diabetes mellitus) linked to 82947 to show the reason for the test.

Note: When testing for diabetes, your FP may also perform a post-glucose test (82950, ... post-glucose dose [includes glucose]) or a glucose tolerance test (82951, ... tolerance test [GTT], three specimens [includes glucose]) instead of the fasting test. No matter which diabetes screening your physician performs, always append V77.1 as the primary diagnosis.