In our electronic health records system only the primary POV can be selected to appear in order. Other than that, the additional diagnosis appear in the order they are entered. As of recently, we have set our billing system to only recognize the first 4 diagnosis when billing medicare. We are a family practice clinic and treat many complicated diabetic patients and it is not unusual to have more than 4 diagnosis for a visit. One of the suggestions to keep diagnosis of conditions addressed at visit in that billing window is to omit the V codes for immunizations. The other fix is to remove and re-sequence the diagnosis in auditing, which is very time consuming. I have been asked to solicit opinions from the coding world.