VaVaVoom: V-Codes Give Your Claims a Smoother Ride

Posted on 08. Apr, 2009 by Editor in Coder's Cranium

So what’s the deal, exactly, with V codes? Here are the basics for anyone who’s afraid to ask.

V codes alone may not have the power to bring in reimbursement, but under certain circumstances you may need to use them as secondary or tertiary codes to illustrate to the payer why your physician performed — and should be reimbursed for — a given procedure.

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For instance, if a physician sees a patient who needs a hearing aid adjustment, the physician may use V53.2x (Fitting and adjustment of other device; hearing aid) to describe the encounter.

Don’t be scared of reporting V codes as primary diagnoses — especially when the patient’s visit is for a screening, a well-patient exam, or to monitor a drug’s effects.

Your carrier may not reimburse office visits that you link to diagnosis codes that do not represent a condition or symptom. But if the patient does not have any symptoms, you should not list a non-present diagnosis code simply for reimbursement purposes. You would be committing fraud.

Also, you may need to use the V codes as primary diagnosis codes when a patient is receiving aftercare as continued treatment or to prevent recurrence.

Warning: You can’t use just any V code as a primary diagnosis code because some are exclusively secondary codes.

Tags: primary diagnosis, secondary diagnosis, tertiary diagnosis, V codes, V53.2