I am trying to code an occupational therapy facesheet and the therapist has used a V54.89 code as primary, then the joint replacement code, followed by the secondary codes. I know an occupational therapy needs a V57.21 code as primary, so I am confused as to how this should be coded. Can I use the V57.21 code as primary, then follow with the V54.89 code and then the joint replacement code of V43.61 and so on. Any help would be appreciated. Thanks for any input. Cindy L., Levi Hospital in Hot Springs, AR