Wiki Question on V22 (normal pregnancy)

[lil]

Im in the state of NJ. We use V22 (normal pregnancy) as our primary dx but are getting denied by Medicaid stating that this is not a valid dx.
Could someone suggest what to do?

 

[damey.figura@gmail.com]

Hi,

Are you using a 4th digit?
V22.0 Supervision of normal first pregnancy
V22.1 Supervision of other normal pregnancy

-Damey Slavens, CPC

 

[mitchellde]

Im in the state of NJ. We use V22 (normal pregnancy) as our primary dx but are getting denied by Medicaid stating that this is not a valid dx.
Could someone suggest what to do?

V22 is a category and cannot be used as a code
V22.0 and V22.1 are first-listed only allowed
V22.2 is secondary only allowed and must have specific documentation to support its use.
All of this is covered in the coding guidelines.

 

[ciarahertzog]

I am in Missouri. What services are being denied? For some things, like ultrasounds, our Medicaid wants a medical problem diagnosis and 'normal pregnancy' doesn't cut it. We also have to get authorizations for everything, so are you sure it is your diagnosis that is getting the claims denied?

 

[cghanbari]

I am in Texas for US we always use V28.3. We do a lot of Medicaid. Depending on which CMO it is We are allowed up to three per pregnancy. We do not have to get anything US authorized. Just a routine ob visit we use V22.0 for first pregnancy and V22.1 for secondard pregnancy.