Radiology Coding Alert

Question: Our radiologist performed a CT of the head without contrast. The diagnosis is suspected acoustic neuroma, which, to my understanding, is an acceptable code for this procedure. We thought we should code first for suspected condition (V71.8, observation and evaluation for suspected conditions not found; observation for other specified suspected conditions) and then for the acoustic neuroma (225.1, benign neoplasm of brain and other parts of nervous system; cranial nerves). How can I report this diagnosis?

Maggie Kissinger
Diversified Billing, Lafayette, Calif.

Answer: You should refrain from using a V-code as a primary diagnosis, if possible. Many insurers do not recognize V-codes, and some even consider them as routine and not payable. Instead, you should code the signs or symptoms the patient presents to the physician that prompted the physician to suspect acoustic neuroma. Many of the symptoms represent a covered diagnosis as well.

You also should refrain from coding the acoustic neuroma without being certain that the patient definitely has this condition. Insurers build a file based on the patients submitted diagnosis codes, so you dont want to document a condition that the patient does not have it will be recorded in his file permanently.