Wiki How would you code for a follow up visit in a Doctor's office for Hematuria?

[Carroll1220]

Good evening!

I have been working about a half hour trying to figure out how to properly code a follow up visit to a doctor's office for a patient with Hematuria.

The patient came in on 6/20 with hematuria for which I coded 599.70. Then the patient returned on 7/1 for a follow up visit and their hematuria was gone when the doctor performed a urinalysis.

I was going to code V67.9 and V13.09 for this visit as the hematuria was no longer there. According to OGCR Section 1.C.18.d.8, a follow up code implies, "that the condition has been fully treated and no longer exists [...]they can be used in conjunction with history codes to provide the full picture of the healed condition and its treatment."

However, when I look up the codes online, they both tell me these V codes are billable codes but they cannot be the primary diagnosis. I am not sure what to code as the primary diagnosis for the second visit, though, as the pt's hematuria was resolved. Any assistance would be truly appreciated!

Thanks so much!
Noelle

P.S. Is it true that Medicare will not reimburse much for a urinalysis done by the physician in his office?

 

[mitchellde]

V67 codes can be used as primary. I am not sure what source you are using that states otherwise. V67.9 is unspecified which in my opinion is not your best choice, I suggest V67.51 or V67.59 as it is not unspecified in the documentation. The V13 codes are secondary only.

 

[Carroll1220]

Thank you!

Good afternoon!

I wanted to Thank you so much for your quickly response! The source I used was ICD9data.com which told me the V67 code could not be primary. I was using that website to double check my codes since I am still a novice coder.

Your feedback was extremely helpful! I wasn't sure if V67.59 could be used for any medicine treatment or just for cancer meds or high risk meds, so I appreciate your response

Have a great day!
Noelle

 

[dcpur67]

quick tip

If you are using an ICD-9 book, there will be a (P) by the V codes that can billed as primaries. There are not many. I have seen this in the Igenix books.
Lisa

 

[mitchellde]

Just be aware that not publishers are up to date on which are primary and which cannot be, with respect to their notations in the tabular section The coding guidelines in the front of the book has a list of first only allowed V codes, within the context of the guidelines for individual V code types it will tell you which are are secondary only, other than those restrictions the rest may be first listed or secondary and be correct.

 

[erjones147]

Noelle, when you are looking up the codes on ICD9DATA, does it say they can't be used as a PRIMARY diagnosis, or can't be used as a PRINCIPAL diagnosis?