Unlock Pay With Anesthesia V Code Counsel

By Author: Nancy Rose
Total Articles: 53
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Do not let yourself caught unawares: Patient history is one element of right Dx coding.


Many medical coders think twice before reporting V codes or simply use them improperly. However, sometimes this section of ICD-9 most aptly describes the reason for the patient's condition. As a matter of fact, V codes are often important to reporting an anesthesia patient's medical history.


If you are not clear on the importance of V codes, here are some expert-approved answers to some oft-asked questions:


Why should I report V codes?


To find out if you should go for a V code, look for documentation in your anesthesiologist's report that'll support physical status modifiers or use of Monitored Anesthesia Care (MAC), according to Kelly Dennis, MBA, ACS-AN, CANPC, CHCA, CPC, CPC-I, owner of Perfect Office Solutions in Leesburg, Fla.
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Knowing that a patient has a history of certain problems (like a history of sudden cardiac arrest) could affect how your provider delivers anesthesia or monitors the patient. The personal history might also aid justify having anesthesia services available (either already providing service or with the anesthesiologist on stand-by) for procedures that might not normally require anesthesia.


Key: V codes aren't only apt as secondary codes. You may sometimes encounter a situation where a V code is required as the primary diagnosis. In some cases, going for a V code might be the only way you will get paid for a service.


According to Julee Shiley, CPC, CCS-P, ACS-AN, if there are chronic conditions that impact the physical status like diabetes, lung disease, or cardiovascular disease, then these should be coded in addition to the present diagnosis codes.


Here's an example: A gastroenterologist requests the anesthesiologist at a colonoscopy as the patient has been resistant to moderate sedation previously. Reporting V15.80 (History of failed moderate sedation) could justify why the anesthesiologist was at the colonoscopy.

Search for symbols indicating V code use


According to Dennis, Coders that aren't aware of the ICD-9 history codes often make mistake and go for the ICD-9 code(s) indicating that the patient has the active or ongoing condition, rather than reporting the compliant and associated patient history code.


If you find it a bit tricky to distinguish primary from secondary V codes, ICD-9 provides you some useful hints. Many versions of the ICD-9 manual use a symbol like 1" or a 2" inside a circle to indicate what order you should report the code (like first listed or primary Dx", first listed or additional," or additional or secondary Dx only"). You will find these indicators next to the code descriptor.


For instance: An anesthesiologist provides MAC to a patient with a history of transient ischemic attack (TIA), an episode in which a person has stroke-like symptoms for less than 24 hours. As per ICD-9, you may go for V12.54 (Stroke [cerebrovascular]) as the primary diagnosis and the reason for the surgery as the secondary diagnosis.


How do I report V codes for anesthesia?


Use of V codes for anesthesia can be quite different from other specialties' use of the codes.