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Difference between V72.31 and V76.2

  1. #11
    Location
    Columbia, MO
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    12,837
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    Medical Coding Books
    perhaps the ins sees no medical necessity if a vaginal pap after a total hyst. If that is the case this is something that should be in your contract and also more importantly in the patient's benefits . It cannot be an arbitrary decision, the patient should have known this, whether they did or not, the point is they should have.

    Debra A. Mitchell, MSPH, CPC-H

  2. #12
    Location
    Buckeye, AZ. USA
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    24
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    For preventative, our clms are submitted with V72.31 for the GYN exam, and V76.2 for the PAP. This seems to work with the payers.

    Martha Sims-Green, BS. CPC

  3. #13
    Location
    Columbia, MO
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    Quote Originally Posted by healthtecsystems View Post
    For preventative, our clms are submitted with V72.31 for the GYN exam, and V76.2 for the PAP. This seems to work with the payers.

    Martha Sims-Green, BS. CPC
    If you look at the post , the issue is the patient has no cervix. also the V72.31 excludes using the V76.2. And the instructions state to add the V76.47. Just because the payer pays something does not mean it was coded correctly. The dx codes must be correct for the patient since it is THEIR diagnosis that you are coding.

    Debra A. Mitchell, MSPH, CPC-H

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