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Ok, I have a hot debate, I follow all guidelines and in my ICD-9 guidelines it shows which V codes are used as primary, additional, or both. I have a co worker that has been using
V43.3 as primary dx for Prothrombin Time Monitoring for Home Anticoagulation Management. Basically she bills out a G0248 or G0249 using the V43.3 dx. Now I have seen the Medicare Claims Processing Manual that states to use V43.3 as one of the dx for this service. My question is this, if our ICD-9 books from the AMA state that the V43.3 code can only be used as a secondary code, is Medicare then saying well we can change the rules and bill this V code primary? Or do we look at this as yes, Medicare says we can use V43.3 but as coders we should know our guidelines and first bill an appropriate primary code?
Anyone, Please respond with some answers to this!!! I really feel that this code should not be billed as a primary dx if that is what our books say but I will admit when wrong if I am. Calling all coders to help figure this out!!! Thanks, Gail Davis, CPC
V43.3 as primary dx for Prothrombin Time Monitoring for Home Anticoagulation Management. Basically she bills out a G0248 or G0249 using the V43.3 dx. Now I have seen the Medicare Claims Processing Manual that states to use V43.3 as one of the dx for this service. My question is this, if our ICD-9 books from the AMA state that the V43.3 code can only be used as a secondary code, is Medicare then saying well we can change the rules and bill this V code primary? Or do we look at this as yes, Medicare says we can use V43.3 but as coders we should know our guidelines and first bill an appropriate primary code?
Anyone, Please respond with some answers to this!!! I really feel that this code should not be billed as a primary dx if that is what our books say but I will admit when wrong if I am. Calling all coders to help figure this out!!! Thanks, Gail Davis, CPC