tci Medicare Compliance & Reimbursement - 2007 Issue 7

MEDICARE PART B: Mistake--Listing Preop 'V' Codes As Primary Without Including Secondary Diagnosis

Don't let 'unacceptable' list scare you away from 'V' codes.Myth: You can never use "V" codes from Medicare's "unacceptable principal diagnosis" edit list as a primary diagnosis.Reality: This edit list applies for inpatient Medicare coding only, says Jeffrey Linzer, Sr., associate medical director for compliance and business affairs at EPG-Children's Healthcare of Atlanta at Egleston. Medicare limits many "V" codes to secondary status for inpatient coding because most "V" codes don't describe the patient's current illness or injury--which is almost certainly the reason for inpatient status.Exception: Part B carrier Empire Medicare Services says in a Sept...

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