I code for radiology (don't have my ICD-9 book at home today) I used an online version and I can't see where it says that it should be used with another code describing the reason for the non-routine test. I think I just can't find it but I believe you that it says that. At any rate, I can defenitely tell you not to put 486 or 227.0 or any other condition. They want you to use another V code but when you put down 486 or anything like that you're saying the patient has pneumonia. I ran into the same problem with aftercare codes I use and I found out that it's okay if you don't always have a second V code. Sometimes there just isn't anything else and that's okay.
Hope that helps.
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