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? appropriate dx code

  1. #1
    Default ? appropriate dx code
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    Pt had CT chest, abdomen and pelvis w/ contrast....hx: h/o nhl, eval for progression

    Impression of the all 3 scans states: No findings to suggest metastatic disease. CT abdomen shows diverticulosis.

    would it be approriate to code V71.1/v10.79????

  2. #2
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    Any advice from anyone?

  3. #3
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    If the only reason they did it was history of nhl then I agree with those Vcodes. The fact that they found diverticulosis makes me wonder if there wasn't more to it than just the history, ie was the patient having abdominal pain?

    Laura, CPC

  4. #4
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    No other clinical signs or symptoms.

    Now I'm wondering if V71.1 is appropriate at all, since the ICD9 book states that this code is to be used when persons WITHOUT a diagnosis are suspected of gaving an abnormal conditions, without signs or symptoms, which requires study, but after examination and observations, is found not to exist.

    Would V10.79 by itself be appropriate? Probably won't get paid.

  5. #5
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    i don't think you can use a v71.1 if there is a history of nhl. The personal history code, i believe can be used as a dx. With regard to reimbursement..good luck.

  6. #6
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    Quote Originally Posted by Kimberley View Post
    No other clinical signs or symptoms.

    Now I'm wondering if V71.1 is appropriate at all, since the ICD9 book states that this code is to be used when persons WITHOUT a diagnosis are suspected of gaving an abnormal conditions, without signs or symptoms, which requires study, but after examination and observations, is found not to exist.

    Would V10.79 by itself be appropriate? Probably won't get paid.

    You may need to clarify this information with the referring physician. If the patient's current history is nhl, then a code from the 202-- would be appropriate. If the nhl is currently in remission, then I would still code as current (see excludes note on v10.79). If however, if it's not "in remission" or currently being treated or is a remote (for instance, more than 5 years) history, then I would use the v10.7 series codes.

    The diverticulosis would be secondary to 202-- but primary to v10.-- In my opinion.


    I hope this helps.
    Danny L. Peoples
    CIRCC,CPC

  7. #7
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    Yes Danny is correct, as far as reimbursement, it is normal to check with scans, every so often to look for recurrence or to stage a cancer, so if the payer balks at paying, then remind them of that! Therefore the use of the V10 code first -listed is not a problem and is appropriate if the documentation supports that code.

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