Wiki Dx V45.01


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I have a question, please help:

Ohana denied the claim while MED paid as 1' carrier due to pacemaker go with first DX V45.01. According to Ohana, DX start with V can't be primary.

Is there anyone have the answer please?

thank you,
V codes can be used as primary, but certain V codes are designated as secondary only allowable. V45.1 is a status code, in the past V45.x codes were designated as secondary only allowable and most codebooks still have it designated this way, however the official coding guidelines has now removed this label as secondary only. It is however only a status code and cannot be use with codes form one of the body system chapters. It also does not communicate why the patient is in your office. So it may not be a denial because it is a V code but it just does not communicate necessary information as to the reason for the encounter. Do you have the documentation for the encounter? what other codes did you submit on this claim?
Thank you for your reply.

I found that Ohana paid for CPT 93289/Dx V45.01 before, I will call them to request reprocessing.

Patient has DX 425.4, 428.22, 458.1 go with CPT 99213/M25 and claim was paid.