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Thread: V70.0 vrs. V72.31, please help!

  1. #11


    AAPC: Back to School
    Where can someone find and print official billing guidelines online? Example: Physician wants to know the exact billing guidelines regarding v70.0 vs v72.31.

  2. #12
    Join Date
    Apr 2007

    Default V70.0 & v72.31

    Please advise I code for several Family Practice offices and the physicians want us to bill a well visit with a gynecological exam. There is an on going discussion, on whether it is appropriate to code a Physical Exam and the well woman on the same date of service. I would like to be able to refer to billing guidelines so if anyone could please tell me if there is a website or link I would greatly appreciate it.

  3. #13


    Per principal first listed DX for V codes in the ICD-9 guidelines V70.0 can only be first listed . So if the gynecological component is done. V72.31 would replace the V70.0

  4. #14


    Quote Originally Posted by lnagai View Post
    If the physical includes pelvic and pap we code V72.31. If physical is done w/out pelvic and pap we code V70.0, but we never use both V70.0 and V72.31 together it's either one or the other. Hope this helps

    L.Nagai, CPC
    You are correct, The ICD-9 guidelines for VCodes that may only be principal/first listed diagnoses goes over this . V70.0 is a first listed only , so if the gynecological component was done it would replace the V70.0 w/ V72.31

  5. #15
    Join Date
    Apr 2007
    Albany, NY


    I work for Family Practice and Internal Meds providers and we bill using both the V70.0 and the V72.31 as the secondary. This is because a V72.31 is not as comprehensive as an annual PE (V70.0). And the V70.0 does not include the Pap Smear, Breast Exam and Pelvic Exam.

    The principal/first listed diagnosis codes list does not include the V72.31 therefore billing the V70.0 as the primary and V72.31 is still acceptable.

    Our office uses the AMA 2015 Professiona Edition for Physicianx ICD 9-CM and under I.C.18.e has a list of diagnosis codes that fall under the principal/first diagnosis.

    Hope this helps.
    Stephanie Livingston, CPC

  6. #16


    There is an excludes note at V72 "Excludes: general medical examination (V70.0-70.4)."
    An excludes note under a code indicates that the terms excluded from the code are to be coded elsewhere. This leaves open the possibility of reporting both codes though it is probably unnecessary since a general medical examination for a woman typically includes the gynecologic exam except when she chooses to see two different physicians for the services or when billing Medicare or other plans that limit coverage of the annual physical.

  7. #17
    Join Date
    Apr 2007


    Put simply V70.0 is annual exam. V72.31 is NOT annual exam WITH Gyno. Its just Gyno. So you have to use both.
    Ben Crocker, CPC-A; Burlington, VT

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