Ob-Gyn Coding Alert

Question: Our payer is denying the lab for screening for cystic fibrosis on a pregnant patient. We-ve used a diagnosis of V28.8 and V77.6, but the payer says this is medically unnecessary. Anything else I should be using?


Virginia Subscriber

Answer: Consult your ob-gyn's documentation. You-ll always base your diagnosis on that, rather than what will be paid.

However, V77.6 (Special screening for cystic fibrosis) is screening the patient for having the disease, not screening to see if she is carrying the gene. The correct secondary code would be V82.71 (Screening for genetic disease carrier status). 

Remember: You-ll still be using V28.8 (Other specified antenatal screening) as your primary diagnosis.

Good idea: Check with the carrier coverage for antenatal screening tests. The payer may be one that includes all screening tests as part of global care.