Ob-Gyn Coding Alert

Using a V code correctly can optimize your reimbursement

If you avoid V codes because they've got a reputation of being a series that doesn't bring reimbursement, you're making a mistake - many payers do reimburse procedures and services linked to these codes. After all, digging into the patient's past may reveal that V codes are often the right and ethical choice.
 
Read through the following questions and choose your answer from the V code word bank. Then turn to page 39 for the answers.  1. When you're doing a hepatitis screening test for a non-pregnant ob-gyn patient, you should report _______ in the absence of any symptoms.  2. A patient comes in for enteritis, but the ob-gyn doesn't order an NST - instead he documents that the patient's enteritis was not complicating the pregnancy. In that case, you should report 558.9 (Other and unspecified noninfectious gastroenteritis and colitis) and ______.  3. A surgeon was unable to complete a surgical procedure because the patient's sedation was ineffective and she resisted the insertion of a speculum. For the diagnosis, you should use 995.2 (Unspecified adverse effect of drug, medicinal and biological substance) plus _______ or _______.  4. If a pregnant patient has been exposed to Parvo but you don't have the definitive test results back yet, you should use 648.9x (Other current conditions classifiable elsewhere) plus ________ for the diagnoses codes.  5. For a patient who has had a tubal ligation but has not made an attempt to have it reversed, the only diagnosis would be _______.  6. When the ob-gyn doesn't get to the patient in time to deliver the baby (she delivers in the emergency department) but does deliver the placenta (59414, Delivery of placenta [separate procedure]), you should report ________ because the emergency-department doctor will report 650 (Normal delivery), assuming there are no other issues complicating the deliver.

CHOICES   V01.79 - Other viral diseases
  V22.2 - Pregnant state, incidental
  V24.0 - Postpartum care and examination; immediately after delivery
  V26.51 - Tubal ligation status
  V64.1 - Surgical or other procedure not carried out because of contraindication
  V64.3 - Procedure not carried out for other reasons
  V73.89 - Other specified viral diseases




 1. ANSWER: V73.89. Because the question states "non-pregnant" patient, this is the V code you would use. However, if the patient is pregnant, you would use V28.8 (Other specified antenatal screening) because this is part of the antenatal screening, says Lana Flatt, CPC, a veteran coder for Ob Gyn Associates in Cookeville, Tenn. 2. ANSWER: V22.2. This code indicates "by the way, the patient is also pregnant," Flatt says. Keep in mind that if the enteritis is complicating the pregnancy, you should report 648.93 (Other current conditions classifiable [...]