Always begin your search through the alphabetic index. Using the tabular section can lead to incorrect coding and denied claims. The appropriate codes must be used to identify diagnosis, symptoms, conditions, problems, complaints, or other reasons for the encounter. Codes that describe symptoms and signs, as opposed to diagnoses, are acceptable for reporting when an established diagnosis has not been confirmed. The V Code section is used when circumstances other than a disease or injury are recorded, such as preventative health checks.
Carriers usually deny preventative services when a sick code is the primary diagnosis.
If another condition is found during a preventative visit, it should be coded second to the V Code, provided it is not treated. If the condition is treated separate from the preventative visit, you can bill an office visit with a 25 modifier to show a separate service on the same day. V Codes identify reasons for services that are not covered by many insurance contracts. Claims are not denied because V Codes were used, but because the reason for service described by the code is excluded by the policy. Chronic diseases treated on an ongoing basis can be coded and reported as often as the patient receives treatment and care for the condition.