National Center for Competency Testing

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Overland Park, KS 66211

COURSE DESCRIPTION

The proper use of ICD9-C-M V Codes is often a question for

coders. To “V” or not to “V”? ICD9-CM provides codes to deal
with encounters for circumstances other than a disease or injury.
Classifications of factors influencing health status and contact
with health service. (Supplemental V01-V84). This continuing
education course describes the guidelines for the use of V Codes
for specified encounters.

Rev 2.0
August 2008

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 COURSE TITLE: A Guide to Coding V Codes

Author: Barbara A. Garner, BS/RHIT

Medical Programs Coordinator (Medical Coding Specialist
and Medical Assisting Program
West Virginia Junior College
Morgantown, West Virginia

Number of Clock Hours Credit: 1.0

Course # 1221508
P.A.C.E. ® Approved: _ Yes X No

OBJECTIVES

Upon completion of this continuing education course, the professional

should be able to:

1. Understand the 4 primary circumstances for the use of V codes.

2. Understand the categories of V Codes.
3. How to Locate V Codes and apply proper ICD9-CM coding rules.
4. Understand the importance of the use of V Codes.
5. Learn the V codes that are designed as the principal diagnosis in
specific situations.
6. Locate the V code tabular.
7. Given case studies, identify the proper V code to assign

Disclaimer

The writers for NCCT continuing education courses attempt to provide factual information based on
literature review and current professional practice. However, NCCT does not guarantee that the
information contained in the continuing education courses is free from all errors and omissions.

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INTRODUCTION
The goal of all healthcare providers is to receive the optimal legal reimbursement for the
services provided while coding to the highest specificity. V codes are often hard to
locate in ICD9, and there is a fear that payors will not accept them. Certain V codes are
designated as the principal (or first-listed) diagnosis in specific situations; others are
assigned as additional codes when it is important to indicate a history, status, or
problem that may affect health care.

V Codes are for use in any healthcare setting. They are not procedure codes and a
corresponding procedure code must accompany a V code to describe the procedure
performed. V codes indicate a reason for an encounter. V codes are used to deal with
occasions when circumstances other than a disease or injury are recorded as
“diagnoses” or “problem”. There are four primary circumstances for the use of V codes:

1. An individual who is not currently sick encounters health care services for a specific
purpose, such as to discuss a problem that is not a disease or injury; e.g., health
screenings.

2. An individual with a known current or resolving disease or injury encounters health

care services for a specific treatment of that disease or injury; e.g., chemotherapy for
malignancy.

3. A problem or circumstance influences an individual’s health status but are not in

themselves a current injury or injury.

4. Newborns, to indicate birth status.

V codes are classified as follows:

• V01-V09 Persons with potential health hazards related to communicable

diseases
• V10-V19 Persons with potential health hazards related to personal and
family history
• V20-V29 Persons encountering health services in circumstances related to
reproduction and development
• V30-V39 Liveborn infants according to type of birth
• V40-V49 Persons with a condition influencing their health status
• V50-V59 Persons encountering health services for specific procedures and
aftercare
• V60-V69 Persons encountering health services in other circumstances
• V70-V82 Persons without reported diagnosis encountered during
examination and investigation of individuals and populations
• V83-V84 Genetics
• V85-V85 Body Mass Index
• V86-V86 Estrogen Receptor Status

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LOCATING V CODES

The format and conventions used throughout the main classification are also used in the
indexes and tabular lists for the V code supplementary classification. Index entries for V
codes are included in the main Alphabetic Index. These are the key main terms to look
under in the ICD9-CM index.
• Admission
• Examination
• History of (personal and family)
• Observation
• Encounter
• Aftercare
• Problem
• Status
• Long term use of medications
• Screening
• Follow-Up
• Evaluation
• Supervision of
• Outcome of delivery
• Procreative management
• Cancellation of (Surgery not done)
• Postpartum care
• Suspected Condition
• Counseling
• Donor
• Exposure/Contact
• Investigation
• Reaction to

Certain V codes can be used only as a principal diagnosis or reason for encounter;
others can be assigned as additional codes, as shown on the following pages.

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1. The following V codes and categories are acceptable only as the first listed
code for either admission or outpatient encounter:

ƒ V20 Health supervision of infant or child

ƒ V22.0 Supervision of normal first pregnancy
ƒ V22.1 Supervision of other normal pregnancy
ƒ V24 Postpartum care and examination
ƒ V24.0 Postpartum care & examination immediately after delivery
ƒ V24.1 Postpartum care & examination of lactating mother
ƒ V 24.2 Routine postpartum follow up
ƒ V 29 Observation & evaluation of newborn for suspected conditions not found
ƒ V29.0 Observation for suspected infectious condition

Exception: A code from the V30-39 may be sequenced before the V29 if it is
the newborn record.

ƒ V30-V39 Live born infants according to type of birth

ƒ V46.12 Encounter for respirator dependence during power failure
ƒ V56.0 Aftercare involving extracorporeal dialysis
ƒ V58.0 Radiotherapy
ƒ V58.1x Encounter for antineoplastic chemotherapy & immunotherapy
ƒ V58.11 Encounter for antineoplastic chemotherapy
ƒ V58.12 Encounter for immunotherapy for neoplastic conditions

When both chemotherapy and radiotherapy are used during the same
episode of care, both codes V58.0 and V58.11 may be assigned with either
one being sequenced first.

ƒ V59.x Donors
ƒ V66.x Convalescence and palliative care

Exception: V66.7 Palliative care

ƒ V68.x Encounters for administrative purposes

ƒ V70.x General medical examination
ƒ V71.x Observation and evaluation for suspected conditions not found
ƒ V72.x Special investigations and examinations

Exceptions: V72.5 Radiological examination not elsewhere classified and

V72.6 Laboratory examination.

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2. Additional Only: Categories and subcategories that may be used only as
additional codes; cannot be the first listed.

ƒ V09.x Infection with drug-resistant microorganisms

ƒ V14.x Personal history of allergy to medicinal agents
ƒ V15.x Other personal history presenting hazards to health

Exception: V15.7 Personal history of contraception

ƒ V21.x Constitutional state in development

ƒ V22.2 Pregnant state, incidental
ƒ V26 Procreative Management
ƒ V26.1 Artificial insemination
ƒ V26.2 Procreative investigation & testing
ƒ V26.21 Fallopian insufflation
ƒ V26.5 Sterilization status
ƒ V27.x Outcome of delivery
ƒ Mother with a single liveborn
ƒ V42.x Organ or tissue replaced by transplant
ƒ V43.x Organ or tissue replaced by other means

Exception: V43.22 Fully implantable artificial heart status

ƒ V44.x Artificial opening status

ƒ V45.x Other postsurgical states

Exception: Subcategory V45.7 Acquired absence of organ

ƒ V46.x Other dependence on machines

Exception: V46.12 Encounter for respirator dependence during power failure

ƒ V49.6x Upper limb amputation status

ƒ V49.7x Lower limb amputation status
ƒ V49.82 Dental sealant status
ƒ V49.83 Awaiting organ transplant status
ƒ V58.6x Long term (current) drug use
ƒ V58.61 Long term (current) use of anticoagulants
ƒ V58.69 Long term (current) drug use; e.g., aspirin therapy
ƒ V60.x Housing, household, and economic circumstances
ƒ V62.x Other psychosocial circumstances
ƒ V64.x Persons encountering health services for specified procedures, not
carried out
ƒ V66.7x Encounter for palliative care
ƒ V84 Genetic susceptibility disease
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3. First or Additional: Categories or subcategories that may be used either as first or
additional codes:

ƒ V01.x Contact with or exposure to communicable disease

ƒ V02.x Carrier or suspected carrier of infectious diseases
ƒ V03.x-V06.x Need for prophylactic vaccination and inoculations
ƒ V07.x Need for isolation and other prophylactic measures
ƒ V08.x Asymptomatic HIV infection status
ƒ V10.x Personal history of malignant neoplasm
ƒ V10.43 Personal history of malignant neoplasm of ovary
ƒ V12.x Personal history of certain other diseases
ƒ V13.x Personal history of other diseases

Exception: V13.4 Personal history of arthritis and V13.69 Personal history of

other congenital malformations.

ƒ V16.x-V19.x Family history of disease

ƒ V23.x Supervision of high-risk pregnancy
ƒ V25.x Encounter for contraceptive management
ƒ V25.01 General counseling on prescription of oral contraceptives
ƒ V25.09 Other general counseling and advice on contraceptive
management
ƒ V25.2 Sterilization
ƒ V26.x Procreative management
ƒ V 26.0 Tuboplasty or vasoplasty after previous sterilization
ƒ V26.21 Fertility testing

Exception: V26.5 Sterilization

ƒ V28.x Antenatal screening

ƒ V43 Organ or tissue replaced by other means
ƒ V43.22 Heart replaced by fully implantable artificial heart
ƒ V45 Other postprocedural states
ƒ V45.7 Postsurgical acquired absence of organ
ƒ V49.81 Postmenopausal status (age related) (natural)
ƒ V50.x Elective surgery for purposes other than remedying health status
ƒ V52.x Fitting and adjustment of prosthetic device and implant of devices
ƒ V52.1 Fitting and adjustment of artificial leg (complete) (partial)
ƒ V53.x Fitting and adjustment of other device
ƒ V54.x Other orthopedic aftercare
ƒ V54.89 Other orthopedic aftercare
ƒ V54.9 Unspecified orthopedic aftercare
ƒ V55.x Attention to artificial openings
ƒ V56.x Encounter for dialysis and dialysis catheter care

Exception: V56.0 Aftercare involving extracorporeal dialysis

ƒ V57.x Care involving use of rehabilitation procedures

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 ƒ V58.3 Attention to surgical dressings and sutures
ƒ V58.30 Encounter for change or removal of nonsurgical wound
dressing
ƒ V58.31 Encounter for change or removal of surgical wound
dressing
ƒ V58.4 Other specified aftercare following surgery
ƒ V58.7 Aftercare following surgery to specified body systems, not elsewhere
classified
ƒ V58.83 Encounter for therapeutic drug monitoring
ƒ V61.x After family circumstances
ƒ V63.x Unavailability of other medical facilities for care
ƒ V65.x Other persons seeking consultation without complaint or sickness
ƒ V67.x Follow-up examination
ƒ V69.x Problems related to style
ƒ V70.0 Routine general medical examination at a health care facility
ƒ V70.1 General psychiatric examination requested by the
authority
ƒ V70.7 Examination of participant in clinical trial
ƒ V70.8 Other specified general medical examinations
ƒ V73x-V82.x Special screening examination
ƒ V82.81 Special screening for osteoporosis
ƒ V82.89 Special screening for other specified conditions
ƒ V83.x Genetic carrier status

Aftercare visit codes cover situations when the initial treatment of a disease or injury
has been performed and the patient requires continued care during the healing or
recovery phase, or for the long term consequences of the disease. The aftercare V
code should not be used if treatment is directed at a current, acute disease or injury.
The current condition would be coded in this case.

Exception to this rule is Codes V58.0 Encounter for radiotherapy and V58.11, Encounter
for antineoplastic chemotherapy (chemotherapy). These codes are to be listed followed
by the diagnosis code when patient’s encounter is solely to receive radiation therapy or
chemotherapy for the treatment of a neoplasm. Should the patient receive both
chemotherapy and radiation therapy during the same encounter code V58.0 and V58.1
may be used together on a record with either one being sequenced first.

Example: Encounter for chemotherapy; breast carcinoma, upper inner quadrant;

chemotherapy.

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ICD-9-CM CODES USED IN TEST QUESTIONS
Code Description Code Description
39.9 OTHER BACTERIAL DISEASES (030-041) 666.14 COMPLICATIONS OCCURRING MAINLY IN THE
Excludes:bacterial venereal diseases (098.0-099.9) COURSE OF LABOR AND DELIVERY (660-669)
bartonellosis (088.0) The following fifth-digit subclassification is for use
039 Actinomycotic infections with categories 660-669 to denote the current
Includes: actinomycotic mycetoma episode of care:
infection by Actinomycetales, such as species of 0 unspecified as to episode of care or not applicable
Actinomyces, Actinomadura, Nocardia, Streptomyces; 1 delivered, with or without mention of antepartum
maduromycosis (actinomycotic); condition
schizomycetoma (actinomycotic) 2 delivered, with mention of postpartum complication
039.9 Of unspecified site 3 antepartum condition or complication
Actinomycosis NOS 4 postpartum condition or complication
Maduromycosis NOS 666.1 Other immediate postpartum hemorrhage
Nocardiosis NOS [0,2,4]
Atony of uterus with hemorrhage
Hemorrhage within the first 24 hours following
delivery of placenta
Postpartum atony of uterus with hemorrhage
Postpartum hemorrhage (atonic) NOS
Excludes: atony of uterus without hemorrhage
(661.2); postpartum atony of uterus without
hemorrhage (669.8)
183.0 183 Malignant neoplasm of ovary and other 733.00 Osteoporosis
uterine adnexa; Excludes: Douglas' cul-de-sac Use additional code to identify major osseous
(158.8) defect, if applicable (731.3)
• 183.0 Ovary
585.9 Chronic kidney disease, unspecified 881.00 Open wound of elbow, forearm, and wrist
Chronic renal disease The following fifth-digit subclassification is for use
Chronic renal failure NOS with 881:
Chronic renal insufficiency 0 forearm
1 elbow
2 wrist
881.0 without mention of complication
650 NORMAL DELIVERY, AND OTHER INDICATIONS
FOR CARE IN PREGNANCY, LABOR, AND
DELIVERY (650-659)
The following fifth-digit subclassification is for use
with categories 651-659 to denote the current
episode of care:
0 unspecified as to episode of care or not
applicable
1 delivered, with or without mention of antepartum
condition
2 delivered, with mention of postpartum
complication
3 antepartum condition or complication
4 postpartum condition or complication
650 Normal delivery
Delivery requiring minimal or no assistance, with or
without episiotomy, without fetal manipulation [e.g.,
rotation version] or instrumentation [forceps] of a
spontaneous, cephalic, vaginal, full-term, single, live
born infant. This code is for use as a single
diagnosis code and is not to be used with any other
code in the range of 630-676.
Use additional code to indicate outcome of delivery
(V27.0)

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TEST QUESTIONS
Guide to Coding V Codes
Course 1221508

Directions:
Before taking the test, read the instructions on how to correctly complete the answer
sheet.
Select the response that best completes each sentence or answers each question
from the information presented in the module.
Code the correct V code for the following questions and additional ICD9
DIAGNOSIS CODES ONLY.
If you are having difficulty answering a question, go to www.ncctinc.com and select
Renewal/CE, then select Updates/Revisions to see if course content and/or a test
question have been revised.

1. Patient admitted for chemotherapy following oophorectomy on previous

admission for carcinoma of the ovary.

a. 183.0
b. V58.11,183.0
c. V58.11, V10.43

2. Patient seen in the physician’s office for removal of sutures from healed open
wound of the forearm.

a. V58.3
b. V56.0
c. 881.00

3. Encounter for renal dialysis for patient with chronic kidney disease, unspecified
hemodialysis.

a. 585.9, 39.9
b. 585.9, V56.0
c. V56.0, 585.9

4. Encounter for removal of cast; cast removal.

a. V54.9
b. V54.89
c. V52.1

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5. The patient is on anticoagulant and the physician orders a prothrombin time (PT)
to be performed in the outpatient department.

a. V58.83, V58.61
b. V58.61
c. V58.69

6. Visit to physician’s office for prescription of birth control pills.

a. V25.09
b. V25.01
c. V25.2

7. Screening for osteoporosis

a. 733.00
b. V82.81
c. V82.89

8. Routine general medical examination

a. V70.0
b. V70.1
c. V70.8

9. Visit to physician for routine postpartum exam; no complications were noted.

a. 650, V27.0
b. 666.14, V24.2
c. V24.2

10. A female patient undergoes fertility testing by fallopian insufflation.

a. V26.21
b. V29.0
c. V26.0

*End of Test*

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