Pathology/Lab Coding Alert

Question: We are trying to link the purified protein derivative (PPD) tuberculosis test to the correct ICD9 Codes. We have been using V03.2, but we think that diagnosis is incorrect because V03.2 is a vaccination code. Which ICD-9 code should we report?


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Answer: You should instead use V74.1 (Special screening examination for bacterial and spirochetal diseases; pulmonary tuberculosis) with 86580 (Skin test; tuberculosis, intradermal). The PPD TB test is an inoculation screening test, not a vaccination.

The TB screening test detects the disease’s presence by inoculating the skin with the TB antigen. The shot given to the patient isn’t a vaccination, which uses an inoculation to confer disease immunity. That’s why you should link the test code to the special screening V code instead of to the vaccination code.

In fact, you will probably never use V03.2 (Need for prophylactic vaccination and inoculation against bacterial diseases; tuberculosis [BCG]). The World Health Organization doesn’t recommend that U.S. physicians administer the BCG vaccine. The inoculation isn’t very effective and interferes with skin test screening. People who receive a TB vaccination can give a false-positive when screened for the disease.