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Pathology/Lab Coding Alert

Reader Questions:

V73.81 Trumps V72.31 for Screening HPV

Published on Thu May 05, 2011

Question: Our lab has an ob-gyn client that orders a screening high risk HPV test as part of a wellness exam for all patients over 30. When the HPV test is positive, we report 795.05 as the diagnosis. The physician office let us know that the insurer pays for screening HPV, but when we report 795.05, the insurer applies the cost of the test to the patient's deductible. Should we use the ob-gyn's wellness exam code (V72.31) as the diagnosis code for the HPV test order?Kansas SubscriberAnswer: No, you should not report V72.31 (Routine gynecological examination). Even if the insurer will cover a screening high risk HPV test, V72.31 is not the correct code to describe the screening. ICD-9 has a text note following V72.31 that states, "Use additional code to identify human papillomavirus (HPV) screening (V73.81)." If the physician orders HPV screening, you should report V73.81 (Special screening examination [...]
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