Use Accurate Diagnosis Code When Ordering Neonatal Tests
Published on Wed May 01, 2002
Pediatricians must order tests on newborns, and some of these tests may be esoteric. Hospitals frequently require pediatricians to provide the proper diagnosis code on lab requisitions. Choosing the correct diagnosis code when you do not yet know a diagnosis means relying on V codes to ensure the appropriate tests are ordered.
Pediatricians should be aware of the full gamut of possible diagnosis codes to use when ordering these tests, including V17.x (Family history of certain chronic disabling diseases), V18.x (Family history of certain other specific conditions), V19.x (Family history of other conditions), V71.89 (Observation for other specified suspected conditions; other specified suspected conditions), V72.x (Special investigations and examinations), V77.x (Special screening for endocrine, nutritional, metabolic, and immunity disorders) and V78.x (Special screening for disorders of blood and blood-forming organs). In addition to choosing the appropriate diagnosis code, pediatricians can bill for obtaining the specimen, either by heel stick (36415*, Routine venipuncture or finger/heel/ear stick for collection of specimen[s]) or venipuncture (36406, Venipuncture, under age 3 years; other vein). If the pediatrician draws blood for a repeat test in the office after the baby has been discharged, you should use these codes as well. You should only bill these CPT codes for tests, however, if you or your lab performs the test. Use the appropriate diagnosis code for ordering the test: either a screening code (V72.x or V77.x) or, if the condition is suspected, a family history code (V17.x-V19x) or a suspected condition code such as V71.89. Screening Tests One test, for phenylketonuria (PKU, 84030), is performed for every baby. The diagnosis code to use when ordering this screening test is V77.3 (Special screening for endocrine, nutritional, metabolic, and immunity disorders; phenylketonuria [PKU]). Although every state requires screening for PKU, this does not necessarily mean that it will be reimbursed, says Charles Scott, MD, FAAP, who practices with Medford Pediatric and Adolescent Medicine in Medford, N.J. Other screening tests may include those for hypothyroidism (84437 and V77.0, thyroid disorders), galactosemia (82776, Galactose-1-phosphate uridyl transferase; screen; and V77.4, galactosemia), maple syrup urine disease (84510, Tyrosine; and V77.7, other inborn errors of metabolism), homocystinuria (82615, Cystine and homocystine, urine, qualitative; and V77.7), biotinidase deficiency (82261, Biotinidase, each specimen; and V77.7), cystic fibrosis (83516, Immunoassay for analyte other than infectious agent antibody or infectious agent antigen, qualitative or semiquantitative; multiple step method; and V77.6, cystic fibrosis), adrenal hyperplasia (83498, Hydroxyprogesterone, 17-d; and V77.7), toxoplasmosis (86777, Toxoplasma; and V75.8,Special screening examination for other infectious diseases; other specified parasitic infections) and hemoglobinopathy (83020, Hemoglobin fractionation and quantitation; electrophoresis [e.g., A2, S, C, and/or F]; and V78.3, Special screening for disorders of blood and blood-forming organs; other hemoglobinopathies). Tests When a Family History Exists A test [...]
