Part B Insider (Multispecialty) Coding Alert

Published on Sun Apr 09, 2006 PDF

Helpful hint: List disease signs and symptoms first

Personal and family history V codes can help you track specific conditions over a patient's lifetime--and get claims paid. Last October, CPT introduced V codes for reporting a patient's personal and family history:

• V13.02--Personal history, urinary (tract) infection

• V17.81--Family history, osteoporosis.

You know that past history includes the patient's experience with illnesses, injuries and treatments. So, if, for example, you find that a patient has a personal history of urinary tract infections, you should report V13.02.

Important: If a patient has signs and symptoms of a disease or condition, you should list those first.

"You should report a urinary tract infection (599.0) upon the first encounter as the primary diagnosis, then wait for it to reoccur to use the V code as an additional diagnosis," says Nadia Noor, CPC, a reimbursement specialist at Austin Diagnosis Clinic in Texas.

Also: First code the symptoms, such as urinary frequency, and then follow up with V13.02, says a manager of ob-gyn services in northern California.

The V code in action: You should apply V17.81 for patients with osteoporosis in their families. A patient with a family history of osteoporosis may be more apt to receive reimbursement for a DEXA bone scan (76075, Dual energy x-ray absorptiometry [DEXA], bone density study,...). Remember, though, that such scans are not routine. The ob-gyn must document medical history supporting the medical necessity for the test--and this new V code can help.