Wiki Vcode as primary Dx.

[LADY_SETSUNA_CJ]

I'm curious, can we use a Vcode as a primary Dx if there is not other Dx problem or disease that can be coded along with it?

Instance: Patient comes in for a routine weight check visit (age 8 days). He's already been seen for his NB well visit and is just returning for a f/u weight check. We code a 99213 for the office visit and a V20.31/2 for the Dx.

Thanks in advance,

________________________

Cheryl Miles, CPC

 

[mitchellde]

Yes V codes can be primary. In fact some V codes are primary only allowed. SUch as the V20.xx are first-listed only allowed.

 

[Faith C Taylor]

Yes, a V code can be used primarily if there is no other dx code but make sure that the insurance accepts a V code.

 

[mitchellde]

Yes, a V code can be used primarily if there is no other dx code but make sure that the insurance accepts a V code.

The insurance must "accept" the V code because it is the patient's diagnosis. We have no choice but to code exactly the dx documented by the physician. The payer can make a decision that the dx we chose is non covered or is not medically indicated but they must accept the dx we assign to the claim.

 

[vbrown0214]

Yes...V codes can be used as primary diagnosis codes. I just question why this baby was brought back in for a weight recheck after it's NB routine visit. This is not something that is routinely done unless there is some issue, IE: failure to thrive. I would get clarification from the physician. Most insurances are not going to cover this if they have already paid for a routine NB visit