There is always alot of debate about this subject and it is not so much a coding discussion as a billing one. I personally use the V code when I have the basic labs, CMP TSH Lipids. The reason being that some insurance companies will pay at 100% as part of the preventative some basic labs as well as the physical itself and they will base their payment on how we code them. I know for the plan that I am in, I MUST have my labs coded with the V code to have them paid 100%. Our benefit pays for one such group of labs per year as part of our preventative benefits. There is nothing wrong with using a dx as a secondary code should you wish to. I tend to use it if the labs are beyond what some companies might consider a necessary preventative lab. It gives me backup just in case. That would be for labs like the CRP or any testing for diabetes/glucose levels, things of that nature.
Hope this helps.
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