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Thread: Is 079.4 a stand alone code?

  1. #1
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    Question Is 079.4 a stand alone code?

    The note under 079 in the tabular section states "This category is provided to be used as an additional code to identify the viral agent in diseases classifiable elsewhere. This category will also be used to classify virus infection of unspecified nature or site."

    To me, this means that 079.X codes are not stand-alone codes and are only secondary to another ICD-9 code.

    If I have a requisition from a doctor (signed by the doctor) that lists the patient's diagnosis as V72.31, 079.4 or V76.2, 079.4....Is this correct coding? Or should there be another code inbetween the V72.31 and the 079.4 to identify the "disease classifiable elsewhere"?

  2. #2
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    If you do not mind reading a little, the document below will help you get the additional diagnoses needed, if the patient presented or has a family history of other possible complications:
    http://apps.ngsmedicare.com/lcd/LCD_L29508.htm

  3. #3
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    Question

    Thank you for the link. It was helpful for background information and the codes that are medically necessary for HPV testing per Medicare.

    Are you stating that 079.4 would need 795.00, 795.01, or 795.02 before it?

  4. #4
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    We can only code what's documented in the medical record. If any of these are not, you must not. The document also details why the testing is done, what complications may come along with the diagnosis.... Does the medical record document any of these?

  5. #5
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    I work for a 3rd party billing company and do not have access to the medical record. I only have the diagnosis the doctor wrote on the requisition, which is V72.31, 079.4.

    Based on the note in the tabular under 079, I am questioning if V72.31, 079.4 is considered correct coding. If yes, I can bill the claim. If no, I need to tell management that the client needs to be informed that 079.4 is not a stand-alone code and should only be secondary to the disease classified elsewhere. Then we can ask the client to review the patient's medical record. The client does not wish to be bothered with questions or requests for additional information. Therefore, I am trying to determine if it is considered correct coding to bill with V72.31, 079.4 or not.

  6. #6
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    Thank you for the detail. You can code V72.31 and 079.4 together, and as you've noted is not necessarily "good" coding. You do not want to include another diagnosis that the patient may carry around with them for the rest of their lives if you are not absolutely certain it is true. I apologize, but I am not comfortable telling you to use an additional ICD-9 without knowing what was documented.

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