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Thread: V codes and Medicaid

  1. #1
    Join Date
    Apr 2007
    Des Moines

    Default V codes and Medicaid

    AAPC: Back to School
    I was told by my coding supervisor that Medicaid does not recognize aftercare V codes for Ortho, and that we were to code as acute fracture each and every time the patient returns to the physician's office. This to me, seems ludicrous as it would screw up statistic data. Is anyone else coding it this way? Thanks!


  2. #2
    Join Date
    Apr 2007
    Columbia, MO


    Medicaid should recognize the V codes as they are an integralpart of the HIPPA mandated code set. The guidelines for ICD-9 which are also mandated instruct on the appropriate usage of the V codes. Coding Clinic 3rd q 2001 states that after initial injury and the initial treatment then it is no longer an acute fx and no longer appropriate to use those codes. It must be coded as a healing fx with the V code. It is entirely possible that the Medicaid in your area is considering fx a global event regardless of how it is billed and therefore will no consider follow up visits payable. I would not code these with acute fx codes, they are by definition healing.

    Debra A. Mitchell, MSPH, CPC-H

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