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Syphillis, Quan Analysis Coding

  1. Default Syphillis, Quan Analysis Coding
    Medical Coding Books
    We have not been successful in receiving reimbursement for this test, code 86593, with the following ICD-9 codes:

    v01.6 Exposure to venereal diseases
    v01.79 Exposure to HIV/other viral diseases/prophylaxis NOS
    v75.9 Special screening for unspec infectious disease
    042 HIV

    The typical rejection code is CO45. Any suggestions?

    Louise Cook

  2. #2
    They won't pay for this if the patient has HIV? That is hard to imagine.

    The only other that I can think of for a screening is V69.2 High-risk sexual behavior but if they aren't paying for the others I doubt this will fly either.

    Sorry not more helpful,

    Laura, CPC, CEMC

  3. Default Syphillis Testing
    Thanks. I'll see if we've tried that one. Louise

  4. #4
    I would use code 097.1, which would justify performing a quantitative test. I would assume the patients who are having this test done already had a positive reaction w 86592 which is the qualitative exam. Seems like the V codes you have been using are not specific enough. A quantitative test is usually ordered after the qualitative test was positive.

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