Reporting International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) V codes seems to cause consternation for many practices. Payer guidelines for use of V codes are in many cases inconsistent with ICD-9-CM guidelines and cause further confusion and aggravation.
This article provides the specific guidelines as found in the ICD-9-CM introduction, sections I and IV, for those codes that are often misused or misunderstood by primary care and specialty pediatricians. Physicians and coders alike should review these guidelines and understand them.
ICD-9-CM codes V01.0–V91.99 (classification of factors influencing health status and contact with health services) are used to report encounters for circumstances other than a disease or injury. As stated in the ICD-9-CM guidelines, section 1.C.18, V codes are primarily used to report the following circumstances:
Codes are reported
A child is seen by her pediatrician because she has been exposed to meningococcus.
Code V01.84 (contact with or exposure...