Wiki V53.31 vs v45.01

[JJENNETT]

If the device clinic bills a 93280 and no permanent changes were made which would be the correct DX code ? V53.31 or V45.01 ?

thanks

 

[mitchellde]

You can use both but the V53.31 is allowed first listed and the V45.01 is secondary only allowed.

 

[sbicknell]

I suggest that the use of both V53.31 and V45.01 is redundant coding. Your CPT shows you are doing a PM eval and the V53.31 explains why. Adding the V45.01 is like saying “I am doing a routine evaluation of a PM and the patient has a PM".

The V45.01 is more appropriate in providing additional info. Such as a patient who presents with a CC of palpitations and has a PM. It would be appropriate to code 785.1 and V45.01 as the presence of the PM is valid additional info for a patient with this CC

 

[deeva456]

For routine PM analysis I use V45.01, not always necessary to provide another dx. We dont have any problems with our claims being denied for billing with one dx. V53.31 is used for battery depletion, "end-of-life" battery status etc.

Dolores, CPC- CCC

 

[sbicknell]

V53.31 Fitting and adjustment of cardiac pacemaker
V45.01 Other postprocedural states

V53.31 is not limited to only routine end-of-life

If you are evaluating the PM unit, code V53.31

If you providing additional relevant information, code V45.01

 

[mitchellde]

For routine PM analysis I use V45.01, not always necessary to provide another dx. We dont have any problems with our claims being denied for billing with one dx. V53.31 is used for battery depletion, "end-of-life" battery status etc.

Dolores, CPC- CCC

If you check the guidelines and the notation in your codebook you will see that V45.01 is a secondary only dx code it cannot be first listed or the only code submitted. To use this code as a first listed code is non compliant. Just because the payer pays does not equate to proper coding.