Symptoms, Signs, and Ill-Defined Conditions, and V Codes: (V Codes and ICD-9-CM Chapter 16, Codes 780-799, and ICD-10-CM Chapters 18 and 21, Codes R00-R99, Z00-Z99)



Symptoms, Signs, and Ill-Defined Conditions, and V Codes


(V Codes and ICD-9-CM Chapter 16, Codes 780-799, and ICD-10-CM Chapters 18 and 21, Codes R00-R99, Z00-Z99)



Learning Objectives



1. Apply and assign the correct ICD-9-CM and ICD-10-CM codes in accordance with Official Guidelines for Coding and Reporting


2. Identify major differences between ICD-9-CM and ICD-10-CM related to the signs and symptoms and V/Z codes


3. Determine when to assign signs and symptoms codes


4. Assign the correct V/Z codes


5. Explain the importance of documentation in relation to MS-DRGs for reimbursement



Abbreviations/Acronyms




















ICD-9-CM Official Guidelines for Coding and Reporting


Please refer to the companion Evolve site for the most current guidelines.




16. Chapter 16: Signs, Symptoms and Ill-Defined Conditions (780-799)


    Reserved for future guideline expansion


Although there are no guidelines in the Chapter 16 section, there are very specific guidelines in the general coding guideline section that address the coding of signs and symptoms, late effects, and impending conditions. Only guidelines applicable to this chapter are included; therefore, the numbering is not sequential.





B General Coding Guidelines



6. Signs and symptoms


    Codes that describe symptoms and signs, as opposed to diagnoses, are acceptable for reporting purposes when a related definitive diagnosis has not been established (confirmed) by the provider. Chapter 16 of ICD-9-CM, Symptoms, Signs, and Ill-Defined conditions (codes 780.0-799.9) contain many, but not all codes for symptoms.



Example


Fever of unknown origin, 780.60 (R50.9)


7. Conditions that are an integral part of a disease process


    Signs and symptoms that are associated routinely with a disease process should not be assigned as additional codes, unless otherwise instructed by the classification.



Example


Headache due to classical migraine, 346.00 (G43.109)


8. Conditions that are not an integral part of a disease process


    Additional signs and symptoms that may not be associated routinely with a disease process should be coded when present.



Example


Ascites due to cirrhosis of the liver, 571.5, 789.59 (K74.60, R18.8)


Apply the General Coding Guidelines as found in Chapter 5 and the Procedural Guidelines as found in Chapter 6.



ICD-10-CM Official Guidelines for Coding and Reporting


Please refer to the companion Evolve site for the most current guidelines.




18. Chapter 18: Symptoms, signs, and abnormal clinical and laboratory findings, not elsewhere classified (R00-R99)


    Chapter 18 includes symptoms, signs, abnormal results of clinical or other investigative procedures, and ill-defined conditions regarding which no diagnosis classifiable elsewhere is recorded. Signs and symptoms that point to a specific diagnosis have been assigned to a category in other chapters of the classification.



a. Use of symptom codes


    Codes that describe symptoms and signs are acceptable for reporting purposes when a related definitive diagnosis has not been established (confirmed) by the provider.


b. Use of a symptom code with a definitive diagnosis code


    Codes for signs and symptoms may be reported in addition to a related definitive diagnosis when the sign or symptom is not routinely associated with that diagnosis, such as the various signs and symptoms associated with complex syndromes. The definitive diagnosis code should be sequenced before the symptom code.


    Signs or symptoms that are associated routinely with a disease process should not be assigned as additional codes, unless otherwise instructed by the classification.


c. Combination codes that include symptoms


    ICD-10-CM contains a number of combination codes that identify both the definitive diagnosis and common symptoms of that diagnosis. When using one of these combination codes, an additional code should not be assigned for the symptom.


d. Repeated falls


    Code R29.6, Repeated falls, is for use for encounters when a patient has recently fallen and the reason for the fall is being investigated.


    Code Z91.81, History of falling, is for use when a patient has fallen in the past and is at risk for future falls. When appropriate, both codes R29.6 and Z91.81 may be assigned together.


e. Coma scale


    The coma scale codes (R40.2-) can be used in conjunction with traumatic brain injury codes, acute cerebrovascular disease or sequelae of cerebrovascular disease codes. These codes are primarily for use by trauma registries, but they may be used in any setting where this information is collected. The coma scale codes should be sequenced after the diagnosis code(s).


    These codes, one from each subcategory, are needed to complete the scale. The 7th character indicates when the scale was recorded. The 7th character should match for all three codes.


    At a minimum, report the initial score documented on presentation at your facility. This may be a score from the emergency medicine technician (EMT) or in the emergency department. If desired, a facility may choose to capture multiple Glasgow coma scale scores.


    Assign code R40.24, Glasgow coma scale, total score, when only the total score is documented in the medical record and not the individual score(s).


f. Functional quadriplegia


    Functional quadriplegia (code R53.2) is the lack of ability to use one’s limbs or to ambulate due to extreme debility. It is not associated with neurologic deficit or injury, and code R53.2 should not be used for cases of neurologic quadriplegia. It should only be assigned if functional quadriplegia is specifically documented in the medical record.


g. SIRS due to Non-Infectious Process


    The systemic inflammatory response syndrome (SIRS) can develop as a result of certain non-infectious disease processes, such as trauma, malignant neoplasm, or pancreatitis. When SIRS is documented with a noninfectious condition, and no subsequent infection is documented, the code for the underlying condition, such as an injury, should be assigned, followed by code R65.10, Systemic inflammatory response syndrome (SIRS) of non-infectious origin without acute organ dysfunction, or code R65.11, Systemic inflammatory response syndrome (SIRS) of non-infectious origin with acute organ dysfunction. If an associated acute organ dysfunction is documented, the appropriate code(s) for the specific type of organ dysfunction(s) should be assigned in addition to code R65.11. If acute organ dysfunction is documented, but it cannot be determined if the acute organ dysfunction is associated with SIRS or due to another condition (e.g., directly due to the trauma), the provider should be queried.


h. Death NOS


    Code R99, Ill-defined and unknown cause of mortality, is only for use in the very limited circumstance when a patient who has already died is brought into an emergency department or other healthcare facility and is pronounced dead upon arrival. It does not represent the discharge disposition of death.


Apply the General Coding Guidelines as found in Chapter 5 and the Procedural Guidelines as found in Chapter 7.



Guideline Differences Between ICD-9-CM and ICD-10-CM


There are no ICD-9-CM guidelines for Chapter 16. There are a number of guidelines related to Chapter 18 in ICD-10-CM, and the guidelines address when to use symptom codes, as do the general guidelines in ICD-9-CM. There are additional guidelines for the following:



The guidelines for V codes and Z codes are fairly similar.





Disease Conditions


Symptoms, Signs, and Ill-Defined Conditions (780-799), Chapter 16 in the ICD-9-CM code book, is divided into the following categories:

















CATEGORY SECTION TITLES
780-789 Symptoms
790-796 Nonspecific Abnormal Findings
797-799 Ill-Defined and Unknown Causes of Morbidity and Mortality

Chapter 18 in the ICD-10-CM code book is divided into the following blocks:


















































CATEGORY SECTION TITLES
R00-R09 Symptoms and Signs Involving the Circulatory and Respiratory Systems
R10-R19 Symptoms and Signs Involving the Digestive System and Abdomen
R20-R23 Symptoms and Signs Involving the Skin and Subcutaneous Tissue
R25-R29 Symptoms and Signs Involving the Nervous and Musculoskeletal Systems
R30-R39 Symptoms and Signs Involving the Urinary System
R40-R46 Symptoms and Signs Involving Cognition, Perception, Emotional State, and Behavior
R47-R49 Symptoms and Signs Involving Speech and Voice
R50-R69 General Symptoms and Signs
R70-R79 Abnormal Findings on Examination of Blood, without Diagnosis
R80-R82 Abnormal Findings on Examination of Urine, without Diagnosis
R83-R89 Abnormal Findings on Examination of Other Bloody Fluids, Substances, and Tissues, without Diagnosis
R90-R94 Abnormal Findings on Diagnostic Imaging and in Function Studies, without Diagnosis
R97 Abnormal Tumor Markers
R99 Ill-defined and Unknown Cause of Mortality

Chapter 21 in the ICD-10-CM code book is divided into the following blocks:


















































CATEGORY SECTION TITLES
Z00-Z13 Persons Encountering Health Services for Examination and Investigation
Z14-Z15 Genetic Carrier and Genetic Susceptibility to Disease
Z16 Infection with Drug-Resistant Microorganisms
Z17 Estrogen Receptor Status
Z18 Retained foreign body fragments
Z20-Z28 Persons with Potential Health Hazards Related to Communicable Disease
Z30-Z39 Persons Encountering Health Services in Circumstances Related to Reproduction
Z40-Z53 Persons Encountering Health Services for Specific Procedures and Health Care
Z55-Z65 Persons with Potential Health Hazards Related to Socioeconomic and Psychosocial Circumstance
Z66 Do Not Resuscitate (DNR) Status
Z67 Blood Type
Z68 Body Mass Index (BMI)
Z69-Z76 Persons Encountering Health Services in Other Circumstances
Z79-Z99 Persons with Potential Health Hazards Related to Family and Personal History and Certain Conditions Influencing Health Status

See Figure 8-2 for details on an instructional note that appears at the very beginning of Chapter 16 of the Tabular List and applies to the entire chapter. This note provides information on the appropriate use of signs and symptoms codes.


image
Figure 8-2 Instructional note that appears at the beginning of Chapter 16.

In ICD-9-CM the V codes and E codes are found in the supplemental sections of the ICD-9-CM code book, and codes are assigned in the same manner as other codes, that is, by looking up the main term in the Alphabetic Index or E code index and verifying the code in the Tabular. The Tabular List for the V codes is located after the Tabular List for Chapter 17, Injury and Poisoning. The Tabular for the E codes follows the V code Tabular List.


A few V code guidelines are explained with the various chapter guidelines; these will be addressed in those chapters. Some of them are repeated in the guidelines for V codes and are reviewed in this chapter. These codes are addressed at the beginning of the book because they apply to all body systems. V codes and signs and symptoms are common throughout this text.



Symptoms


A symptom is subjective evidence of a disease or of a patient’s condition as perceived by the patient.



Example


The patient presents to the ER complaining of a severe headache. The headache is an example of a symptom because it is a description of the patient’s condition as perceived by the patient, 784.0 (R51).


A sign is objective evidence of a disease or of a patient’s condition as perceived by the patient’s examining physician.



Example


The patient has a fever. This can be discerned by noting the patient’s elevated temperature, 780.60 (R50.9).


It can be difficult to determine whether a sign or a symptom from Chapter 16 is routinely associated with the disease. It may be necessary to access resource books, such as Merck’s Manual, or the Internet to find the most common symptoms of a disease or condition. As was previously stated in Chapter 5 of this text, signs and symptoms codes are acceptable to code:



It is not acceptable to code signs or symptoms:




Example


Fever due to pneumonia, 486 (J18.9).


Fever is one of the symptoms of pneumonia that is integral to the disease process.


Only the pneumonia should be coded.



Example


Dehydration due to pneumonia, 486, 276.51 (J18.9, E86.0).


Although many patients who are admitted to the hospital may be dehydrated, not all patients who have pneumonia become dehydrated.



Example


Patient was admitted with right lower quadrant abdominal pain with nausea and vomiting. Patient has a low-grade fever. A diagnosis of acute appendicitis was confirmed upon removal of the patient’s appendix in the Operating Room (OR), 540.9, 47.09 (K35.80, ODTJOZZ). The fever, abdominal pain, and nausea/vomiting are all symptoms of appendicitis and are not coded.



Exercise 8-1


Assign codes to the following conditions.








































 1. Alteration in mental status _______________
 2. Fever of unknown origin (FUO) _______________
 3. Right upper quadrant abdominal pain due to cholecystitis versus peptic ulcer disease _______________
 4. Ascites due to cirrhosis of liver _______________
 5. Oliguria _______________
 6. Renal colic _______________
 7. Change in bowel habits _______________
 8. Substernal chest pain _______________
 9. Loss of appetite _______________
10. Ataxia _______________
11. Generalized pain _______________
12. Delirium _______________


Nonspecific Abnormal Findings


Many times, an abnormality or elevation in a test result will lead to further investigation or repeat performance of certain tests. The patient may be without any signs or symptoms, and no definitive diagnosis may explain the abnormality. Some of the main terms that may be used to assist with location of these codes include “abnormal,” “abnormality,” “abnormalities,” “elevation,” and “findings, abnormal, without diagnosis.” These abnormal findings must be documented by the physician to be coded. A coder should not code an abnormal finding on the basis of a review of laboratory results or reports of other diagnostic procedures (Coding Clinic 1990:2Q:p15-16).1



Example


Elevated blood pressure. Patient does not have a history of hypertension, 796.2 (R03.0).



Example


Abnormal lung x-ray. Patient will be scheduled for a computerized tomography (CT) of the chest, 793.19 (R91.8).



Exercise 8-2


Assign codes to the following conditions.


































 1. Significant drop in hematocrit _______________
 2. Abnormal coagulation profile _______________
 3. Proteinuria _______________
 4. Abnormal Pap smear with atypical squamous cells of undetermined significance (ASCUS) _______________
 5. Abnormal mammogram _______________
 6. Bacteremia _______________
 7. Abnormal lead levels in blood _______________
 8. Positive Mantoux test _______________
 9. Elevated CA-125 _______________
10. Transaminasemia _______________




Factors Influencing Health Status and Contact with Health Services (V Codes/Z Codes)


The V codes are located after Chapter 17 in the Tabular List. According to the guidelines, ICD-9-CM provides codes that should be assigned to encounters for circumstances other than a disease or injury. The Supplementary Classification of Factors Influencing Health Status and Contact with Health Services (V01.0-V91.99) is provided to deal with occasions when circumstances other than a disease or injury (codes 001-999) are recorded as a diagnosis or problem. In ICD-10-CM, the Z codes are located in Chapter 21.



18. Classification of Factors Influencing Health Status and Contact with Health Service (Supplemental V01-V89)


    Note: The chapter specific guidelines provide additional information about the use of V codes for specified encounters.



a. Introduction


    ICD-9-CM provides codes to deal with encounters for circumstances other than a disease or injury. The Supplementary Classification of Factors Influencing Health Status and Contact with Health Services (V01.0-V91.99) is provided to deal with occasions when circumstances other than a disease or injury (codes 001-999) are recorded as a diagnosis or problem.


    There are four primary circumstances for the use of V codes:



1) A person who is not currently sick encounters the health services for some specific reason, such as to act as an organ donor, to receive prophylactic care, such as inoculations or health screenings, or to receive counseling on health related issues.



Example


The patient was admitted to donate a kidney for a brother’s kidney transplant. A right nephrectomy was performed without complication, V59.4, 55.51 (Z52.4, 0TT00ZZ).


2) A person with a resolving disease or injury, or a chronic, long-term condition requiring continuous care, encounters the health care system for specific aftercare of that disease or injury (e.g., dialysis for renal disease; chemotherapy for malignancy; cast change). A diagnosis/symptom code should be used whenever a current, acute, diagnosis is being treated or a sign or symptom is being studied.



Example


Patient with hydrocephalus was admitted for removal of ventricular shunt, V53.01, 331.4, 02.43 (Z45.41, G91.9, 00P60OZ).


3) Circumstances or problems influence a person’s health status but are not in themselves a current illness or injury.



Example


A patient was admitted with congestive heart failure and coronary artery disease. The patient has a history of coronary artery bypass graft and a family history of coronary artery disease, 428.0, 414.00, V45.81, V17.3 (I50.9, I25.10, Z95.1, Z82.49).


4) Newborns, to indicate birth status



Example


A newborn is delivered by vaginal delivery and receives prophylactic vaccination for hepatitis B before discharge, V30.00, V05.3, 99.55 (Z38.00, Z23, 3E0134Z).



Example


Healthy liveborn twins born via cesarean section: Twin A, V30.01 (Z38.31); Twin B V30.01 (Z38.31).


b. V codes use in any healthcare setting


    V codes are for use in any healthcare setting. V codes may be used as either a first listed (principal diagnosis code in the inpatient setting) or secondary code, depending on the circumstances of the encounter. Certain V codes may only be used as first listed, others only as secondary codes.


    See Section I.C.18.e, V Codes That May Only be Principal/First-Listed Diagnosis.


c. V Codes indicate a reason for an encounter


    They are not procedure codes. A corresponding procedure code must accompany a V code to describe the procedure performed.



Example


A female patient was admitted for elective sterilization and percutaneous endoscopic bilateral tubal occlusion with Falope ring was performed, V25.2, 66.29 (Z30.2, OUL74CZ).


d. Categories of V Codes



1) Contact/Exposure


    Category V01 indicates contact with or exposure to communicable diseases. These codes are for patients who do not show any sign or symptom of a disease but have been exposed to it by close personal contact with an infected individual or are in an area where a disease is epidemic. These codes may be used as a first listed code to explain an encounter for testing, or, more commonly, as a secondary code to identify a potential risk.


    Codes V15.84-V15.86 describe contact with or (suspected) exposure to asbestos, potentially hazardous body fluids, and lead.


    Subcategories V87.0-V87.3 describe contact with or (suspected) exposure to hazardous metals, aromatic compounds, other potentially hazardous chemicals, and other potentially hazardous substances.



Example


Exposure to anthrax, V01.81 (Z20.810).


2) Inoculations and vaccinations


    Categories V03-V06 are for encounters for inoculations and vaccinations. They indicate that a patient is being seen to receive a prophylactic inoculation against a disease. The injection itself must be represented by the appropriate procedure code. A code from V03-V06 may be used as a secondary code if the inoculation is given as a routine part of preventive health care, such as a well-baby visit.



Example


Vaccination for influenza, V04.81, 99.52 (Z23, 3E0134Z).


3) Status


    Status codes indicate that a patient is a carrier of a disease, has the sequelae or residual of a past disease or condition, or has another factor influencing a person’s health status. This includes such things as the presence of prosthetic or mechanical devices resulting from past treatment. A status code is informative, because the status may affect the course of treatment and its outcome. A status code is distinct from a history code. The history code indicates that the patient no longer has the condition.


    A status code should not be used with a diagnosis code from one of the body system chapters, if the diagnosis code includes the information provided by the status code. For example, code V42.1, Heart transplant status, should not be used with code 996.83, Complications of transplanted heart. The status code does not provide additional information. The complication code indicates that the patient is a heart transplant patient.


Assignment of V codes can be problematic because some can be used only as the principal diagnosis, others can be used as both principal and secondary diagnoses, and some can be used only as secondary diagnoses. It can be difficult to locate V codes in the Alphabetic Index. Coders will often say, “I did not know there was a V code for that.” It is very important to be familiar with the different types and uses of V codes. Because appropriate main terms are difficult to find in the Alphabetic Index, some common main terms are as follows:












































Admission Donor Procedure (surgical)
Aftercare Examination Prophylactic
Attention to Fitting of Replacement
Boarder Follow-up Screening
Care (of) Health, Healthy Status
Carrier History Supervision (of)
Checking Maintenance Test
Contraception Maladjustment Transplant
Counseling Observation Unavailability of medical facilities
Dialysis Problem Vaccination

Guidelines for V codes provide a lot of detail and descriptions of the various sections of V codes. It may be necessary to review these guidelines frequently; V codes will also be addressed in most of the following chapters because some V codes are specific to certain body systems.


Screening V codes should be assigned only when the service fits the definition of a screening. A screening examination is one that occurs in the absence of any signs or symptoms. It consists of examination of an asymptomatic individual to detect a given disease, typically by means of an inexpensive diagnostic test. There are V codes for prophylactic organ removal. A prophylactic measure is the use of medication or treatment to prevent a disease from occurring.



Example


Screening mammogram for 45-year-old patient, V76.12 (Z12.31).



Example


Screening mammogram in a 45-year-old patient with nipple discharge, 611.79 (N64.52).


In this case, even though it was documented as a screening mammogram, it does not fit the definition because the nipple discharge is a symptom and a reason for the test. It would be inappropriate to assign the screening V code.


Several V codes identify the history of certain conditions. Documentation of a patient’s medical and surgical history may be found within the History and Physical or the Admit Note.


Sometimes, documentation in the health record may indicate a history of a particular disease or condition, and the disease or condition is actually a current or active problem. If any question arises as to whether a condition is currently an active problem, a physician query may be necessary.


Relevant family history is often documented. It may be important to code a family history of malignant neoplasm of the breast when a patient has been admitted with breast cancer and is having a mastectomy. In the Index under “History,” “Family history” is a subterm, and it may be difficult to locate where the family history subterms start and stop (Figure 8-3).


image
Figure 8-3 Family history subterms.


Example


Patient has a past history of chronic obstructive pulmonary disease (COPD). You would not assign a V code to indicate a previous history of a respiratory condition but the code for the active disease. COPD is a chronic condition that cannot be cured, 496 (J44.9).



Example


The patient has a history of urinary tract infections (UTIs). In this case, no documentation, such as antibiotic therapy, indicates that the patient currently has a UTI, so a history of UTI V code is appropriate, V13.02 (Z87.440).



Example


Patient has a history of thrombocytopenia. The physician documents that the patient still has a low platelet count (thrombocytopenia and low platelets are assigned the same code). A V code is not necessary as the patient continues to be thrombocytopenic, 287.5 (D69.6).


The status V codes/categories are:

















































































































































V02 Carrier or suspected carrier of infectious diseases
  Carrier status indicates that a person harbors the specific organisms of a disease without manifest symptoms and is capable of transmitting the infection.
V07.5X Use of agents affecting estrogen receptors and estrogen level
  This code indicates when a patient is receiving a drug that affects estrogen receptors and estrogen levels for prevention of cancer.
V08 Asymptomatic HIV infection status
  This code indicates that a patient has tested positive for HIV but has manifested no signs or symptoms of the disease.
V09 Infection with drug-resistant microorganisms
  This category indicates that a patient has an infection that is resistant to drug treatment. Sequence the infection code first.
V21 Constitutional states in development
V22.2 Pregnant state, incidental
  This code is a secondary code only for use when the pregnancy is in no way complicating the reason for visit. Otherwise, a code from the obstetric chapter is required.
V26.5x Sterilization status
V42 Organ or tissue replaced by transplant
V43 Organ or tissue replaced by other means
V44 Artificial opening status
V45 Other postsurgical states
  Assign code V45.87, Transplant organ removal status, to indicate that a transplanted organ has been previously removed. This code should not be assigned for the encounter in which the transplanted organ is removed. The complication necessitating removal of the transplant organ should be assigned for that encounter.
  See Section I.C17.f.2. for information on the coding of organ transplant complications.
  Assign code V45.88, Status post administration of tPA (rtPA) in a different facility within the last 24 hours prior to admission to the current facility, as a secondary diagnosis when a patient is received by transfer into a facility and documentation indicates they were administered tissue plasminogen activator (tPA) within the last 24 hours prior to admission to the current facility.
  This guideline applies even if the patient is still receiving the tPA at the time they are received into the current facility.
  The appropriate code for the condition for which the tPA was administered (such as cerebrovascular disease or myocardial infarction) should be assigned first.
  Code V45.88 is only applicable to the receiving facility record and not to the transferring facility record.
V46 Other dependence on machines
V49.6 Upper limb amputation status
V49.7 Lower limb amputation status
  Note: Categories V42-V46, and subcategories V49.6, V49.7 are for use only if there are no complications or malfunctions of the organ or tissue replaced, the amputation site or the equipment on which the patient is dependent.
V49.81 Asymptomatic postmenopausal status (age-related) (natural)
V49.82 Dental sealant status
V49.83 Awaiting organ transplant status
V49.86 Do not resuscitate status
  This code may be used when it is documented by the provider that a patient is on do not resuscitate status at any time during the stay.
V49.87 Physical restraint status
  This code may be used when it is documented by the provider that a patient has been put in restraints during the current encounter. Please note that this code should not be reported when it is documented by the provider that a patient is temporarily restrained during a procedure.
V58.6x Long-term (current) drug use
  Codes from this subcategory indicate a patient’s continuous use of a prescribed drug (including such things as aspirin therapy) for the long-term treatment of a condition or for prophylactic use. It is not for use for patients who have addictions to drugs.
  This subcategory is not for use of medications for detoxification or maintenance programs to prevent withdrawal symptoms in patients with drug dependence (e.g., methadone maintenance for opiate dependence). Assign the appropriate code for the drug dependence instead.
  Assign a code from subcategory V58.6, Long-term (current) drug use, if the patient is receiving a medication for an extended period as a prophylactic measure (such as for the prevention of deep vein thrombosis) or as treatment of a chronic condition (such as arthritis) or a disease requiring a lengthy course of treatment (such as cancer). Do not assign a code from subcategory V58.6 for medication being administered for a brief period of time to treat an acute illness or injury (such as a course of antibiotics to treat acute bronchitis).
V83 Genetic carrier status
  Genetic carrier status indicates that a person carries a gene, associated with a particular disease, which may be passed to offspring who may develop that disease. The person does not have the disease and is not at risk of developing the disease.
V84 Genetic susceptibility status
  Genetic susceptibility indicates that a person has a gene that increases the risk of that person developing the disease.
  Codes from category V84, Genetic susceptibility to disease, should not be used as principal or first-listed codes. If the patient has the condition to which he/she is susceptible, and that condition is the reason for the encounter, the code for the current condition should be sequenced first. If the patient is being seen for follow-up after completed treatment for this condition, and the condition no longer exists, a follow-up code should be sequenced first, followed by the appropriate personal history and genetic susceptibility codes. If the purpose of the encounter is genetic counseling associated with procreative management, a code from subcategory V26.3, Genetic counseling and testing, should be assigned as the first-listed code, followed by a code from category V84. Additional codes should be assigned for any applicable family or personal history.
  See Section I.C. 18.d.14 for information on prophylactic organ removal due to a genetic susceptibility.
V85 Body Mass Index (BMI)
V86 Estrogen receptor status
V88 Acquired absence of other organs and tissue
V90 Retained foreign body

Related posts:

  1. Diseases of the Digestive System: (ICD-9-CM Chapter 9, Codes 520-579, and ICD-10-CM Chapter 11, Codes K00-K95)
  2. Diseases of the Blood and Blood-Forming Organs: (ICD-9-CM Chapter 4, Codes 280-289, and ICD-10-CM Chapter 3, Codes D50-D89)
  3. Diseases of the Circulatory System: (ICD-9-CM Chapter 7, Codes 390-459, and ICD-10-CM Chapter 9, Codes I00-I99)
  4. Introduction to ICD-10-PCS

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Jun 14, 2017 | Posted by in GENERAL SURGERY | Comments Off on Symptoms, Signs, and Ill-Defined Conditions, and V Codes: (V Codes and ICD-9-CM Chapter 16, Codes 780-799, and ICD-10-CM Chapters 18 and 21, Codes R00-R99, Z00-Z99)

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