Oncology & Hematology Coding Alert

Question: When is use of V71.1 correct?

Arizona Subscriber

Answer: Code V71.1 (Observation for suspected malignant neoplasm) is an observation V code that ICD-9 guidelines indicate is "for use in very limited circumstances when a person is being observed for a suspected condition that is ruled out."

Crucial: Do not use V71.1 "if an injury or illness or any signs or symptoms related to the suspected condition are present," the guidelines instruct.

So if documentation indicates the physician suspects a neoplasm because the patient is experiencing pain, for example, you should report the appropriate pain diagnosis code rather than reporting V71.1.

If you do have a situation that merits V71.1, remember that ICD-9 indicates this code is appropriate as a principal diagnosis only. You may use additional codes, "but only if they are unrelated to the suspected condition being observed," the guidelines state.

Resource: ICD-9 official guidelines are available online at www.cdc.gov/nchs/icd/icd9cm_addenda_guidelines.htm, and you can find the information on V71.x codes in section I.C.18.d.6.