Primary Care Coding Alert

Question: How should we report V72.81? One interpretation is to assign it only if the scheduled surgery is cardiac-related. Another interpretation is that it can be assigned for other types of surgery (e.g., cataract), but only if the patient has an existing cardiac problem. We have similar discussions about V72.82. Can you tell us how to use these codes?

Maine Subscriber

Answer: Use of these V codes does not depend on the type of surgery. They describe the system being evaluated prior to surgery. Therefore, V72.81 (Other specified examinations, pre-operative cardiovascular examination) may be used for a cardiac assessment prior to any operation, if the medical necessity for such an evaluation is demonstrated. The same is true for the pulmonary assessment described in V72.82 (Other specified examinations, pre-operative respiratory examination). Different payers may have different requirements for when they will pay for preoperative assessments, so it would be wise to check with your carrier before conducting the exam.

Answers to You Be the Coder and Reader Questions provided by Kent Moore, manager of Health Care Financing and Delivery Systems for the American Academy of Family Physicians; Brett Stanaland, MD, allergist immunologist at Naples Community Hospital in Naples, Fla., and assistant clinical professor of medicine at the University of South Florida; and Judy Richardson, RN, MSA, CCS-P, at Hill & Associates, a coding and compliance consulting company in Wilmington, N.C.