Primary Care Coding Alert

Question: The family physician orders a screening Pap smear, as he suspects his patient may have been exposed to an STD. What would the diagnosis for this be? New York Subscriber Answer: Code V69.2 (High-risk sexual behavior) with secondary diagnosis of V15.89 (Other specified personal history presenting hazards to health; other). This may easily be confused with V74.5 (Special screening examination for bacterial and spirochetal diseases; venereal disease); however, considering that sexually transmitted disease (STD) infections are not entirely bacterial or spirochetal, using V74.5 might not be appropriate. ICD-9-CM does not specify what "high risk" means  with respect to V69.2. However, Medicare lists several high risk factors for cervical and vaginal cancer that may be used as a guide in this regard. Those risk factors include: • Early onset of sexual activity (under 16 years of age) • Multiple sexual partners (five or more in a lifetime) • History of [...]