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

  1. Default V70.0 vrs. V72.31, please help!
    Medical Coding Books
    I code for multiple Family Practice offices and there is an on going discussion, whether it is appropriate to code a Physical Exam done with a pap and pelvic, breast done with the V70.0 or the V72.31. The problem is that the documentation states patient is here for the annual physical exam. That would direct me to use the V70.0 but they are doing the pap and pelvic, breast so should this be coded as the V72.31. I have queried some of my co-workers and they are coding this scenario with the V70.0 primary and the V72.31 secondary...this just does not seem right to me?????

    Thank you for any input you have

  2. #2
    Default
    I have done billing for both Gyn and internal med. Whenever a patient came in for her yearly, I would code as V72.31 IF she is getting pelvic exam ( without of without a pap smear)
    Thats my opinion , for what it is worth

    Good luck!

  3. #3
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    I would use both if a preventive visit is being preformed and billed in addition to the pelvic exam otherwise if it just the pelvic and you are billing a new or established visit I would only use the v72.31

  4. #4
    Location
    Pottstown/Philadelphia
    Posts
    266
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    I would use the v70.0 for the annual and the v72.31 if the pap was done and it wasn't an expected part of the annual. Also, I know there is a hospital code for manual breast exam (89.36) but i have used v76.19 for a breast exam in pcp. someone please correct me if that is wrong!! I use that for SNF too.

  5. Default v72.31 VS v70.0
    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

  6. #6
    Location
    Anchorage, AK
    Posts
    31
    Default
    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

    We code this way also, we never use both but one of my colleague disagrees, she codes V70.0 with V72.31. What is your reasoning on why you code this way? Maybe coming from an outside source will help my colleague understand. Thanks!

  7. #7
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    I code with the V70.0 and V72.31 codes very often. V70.0 would be used for annual exams, and V72.31 would be for a pap smear/gynecological exam. I work in a doctors office in Scottsdale, Arizona. Hope this helps!!

  8. #8
    Location
    Columbia, MO
    Posts
    12,843
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    Quote Originally Posted by jifnif View Post
    I would use the v70.0 for the annual and the v72.31 if the pap was done and it wasn't an expected part of the annual. Also, I know there is a hospital code for manual breast exam (89.36) but i have used v76.19 for a breast exam in pcp. someone please correct me if that is wrong!! I use that for SNF too.
    the 89.36 is a volume 3 procedure code for inpatient facility use only, V76.19 is the diagnosis code used in all settings for a breast screening.

    Debra A. Mitchell, MSPH, CPC-H

  9. #9
    Location
    Overland Park, KS
    Posts
    1,166
    Default
    You do not use V70.0 and V72.31 together. There is a Coding Clinic guidance around this (I have heard). If the visit is for the patient's annual exam and the GYN is not performed, you use V70.0. If the annual exam includes the GYN component, you use V72.31.
    Dawson Ballard, Jr., CPC, CEMC, CPMA, CCS-P, CPC-P, CRHC, AAPC Fellow
    Coder

  10. #10
    Location
    Spokane, WA
    Posts
    20
    Default v70.0 vs v72.31
    Does anyone know where to find the Coding Clinic guidelines regarding this issue?
    ScottShar

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