v code question


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:confused: Pt with a milignancy, being treated w chemo. We provide a pre-chemo ejection fraction, and a post chemo ejection fraction via echo. What is an appropriate v code to describe this service? I have looked at v58, v67.2,v72.84. v72.85, and v81.2. None of them seem to be exactly correct, so I am wondering what everyone else out there is doing! Thanks so much!
I can't really vouch for specifics because my coding "assignment" changes from day to day. However, it is common for a "pre-chemo" echo, etc to be done for these folks.

The malignancy should certainly be reported, but make sure that's secondary (unless requested as Primary). The V58s are not where you need to be, probably not in the V67s either. Although I know of a particular payer who loves the screening codes, according to ICD, there are specific circumstances that must be met before we can use those. I wouldn't rule them out, but make sure nothing else is availble--including signs, symptoms and history.

The V72.85 I might be inclined to use; what you must keep in mind here is that there's a reason (clinically) behind the request for the echo. I'd scan the order and begin to require the "referring" providers to give a better reason than "pre-chemo" for the request. The other V72.8 codes specify "pre-operative". Chemo is not operative in nature, so I agree, those aren't correct. V72.85 does not specify "pre-op", so we're closer to the target.

As I mentioned above, look for the real reason those diagnostics are requested. The patient may have a family history, personal history or existing cardio disease which prompts investigation prior to the rigors of chemo.

To conclude, I'd be inclined to use V72.85 as my primary if I had nothing else.

Hope this helps and perhaps someone else will have a more specific recommendation. (Definitely pursuade the orders to require more, if you can.)

Good luck.