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Diagnosis code- with the ICD9 code

  1. Default Diagnosis code- with the ICD9 code
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    Can someone help me with the ICD9 code when the doc is just checking dates/size and/or anatomy/growth. We used to bill as V22.0 but those started getting denied so we were told to use 649.60 but that code is being denied as well. Any suggestions?

  2. #2
    Columbia, MO
    I am curious as to why you would use 649.60 rather than the V22.0. These are not equivalent codes at all. The V22.0 is a supervision of a normal first preganancy and 649.60 is other condition of the mothercompliction the pregancy, a uterine size date discrepancy, and then you indicate unspecified as to whether this is during the pregnancy or postpartum etc.
    If this is a normal size date check then you use the V22.0, if the payer does not pay then it is probably due to this being global. If there is no problem with the preganancy or the mother then as a coder you are not to diagnose one and code it just to get a claim to pay.

    Debra A. Mitchell, MSPH, CPC-H

  3. #3
    I always code this as V22.2

  4. #4
    Columbia, MO
    Quote Originally Posted by samanthat View Post
    I always code this as V22.2
    V22.2 is not allowed as a first listed code, and if the doc is checking the fetal size then the preganancy is NOT incidental.

    Debra A. Mitchell, MSPH, CPC-H

  5. #5
    Here is some info found in July's OBGYN Coding Alert:
    If your ob suspects size/date discrepancy but rules it out, you can report V89.04 (Suspected problem with fetal growth not found).
    To check for size/date discrepancy that the ob-gyn does not rule out, the code is 649.63 (Uterine size date discrepancy; antepartum condition or complication).
    If the fetus appears larger or smaller than normal in relation to the EDC, then 656.53 (Poor fetal growth, affecting management of mother; antepartum condition or complication) or 656.63 (Excessive fetal growth affecting management of mother antepartum) are the correct options.

    Hope that helps....Becky, CPC

  6. Default
    Watch your payor, I just had this problem and in research you really need a suspected problem, or know problem before they will pay more than one. If it is size, is it large for dates?(656.63 or small 656.53) Most of the insurances websites will give you an allowable listing of Dx for each U/S. Also, make sure the Dr clearly states the problem before Dx.

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