Wiki follow up xray

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lmlaprise

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For a medicare patient, what is the correct way to report a follow up chest xray. FIrst xray was taken approximately 5 weeks ago and pt in for follow-up. Do you code the underlying codition first and then the V code to report follow-up?
 
I am not sure what is correct or not, but for our radiology reports, I try to avoid V codes as much as possible because all the insurances like to deny them. But if I have to use them, I try not to use them as primary. Sometimes you can't avoid it because there is nothing else. I know Medicare especially likes to deny V70.0 , V72.5 and I think it's V71.2.

So personally if I was coding your report I would code the underlying condition first and then the V code second.
 
Follow-up x-ray

I can give you a scenario that may shed a little light on your situation.

If a patient is sent for a chest x-ray say on November 1, 2009 and the impression is pneumonia and the treating physician says come back in 4 weeks and we will re-examine you and send you for a follow-up x-ray, the rule of thumb is that the patient, while in 4 weeks may clinically be "healed" and no longer have those clinical findings of penumonia, they are not radiologically free of the pneumonia until an x-ray is done. So, when they present to the Radiology lab for that follow-up x-ray, for all intents and purposes, they continue to carry the diagnosis of pneumonia until that x-ray is read and the impression states negative/normal/no pneumonia (or however they choose to phrase it).

I hope this helps put it in perspective...coding, the ever changing (and frustrating) career!

Have a great holiday!

Joyce
 
Thanks a bunch Joyce. That was a wonderful way to explain this. I will remember this the next time this situation presents.

Happy Holidays.

Laura
 
Follow-up x-ray

You are very welcome. I am all for easy...when things get too technical, they often don't find a home in (what's left of) my brain...as I always say, slim pickins when it comes to my brain cells.

Take care :)

Joyce
 
its to late to sent a message for your posting on 12-23-09 to laura
But it was great !! I think the same way as you. 5 thumb up !!!!
Why you nickname is guru ???
 
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