Pregnancy Testing - Coding for CHC Encounter
We have a question – v72.40 – pregnancy unconfirmed, v72.41 pregnancy negative test, v72.42 pregnancy, positive test
Patients come in and wants to know if they are pregnant. We do the pregnancy test (HCG) this test will either read out negative or positive – we have used the above dx codes v72.41(Neg) or v72.42(Pos). If a provider does this test and then wants to confirm the test by doing a venipucture and sends out to lab then we use the v72.40.
I have read in the coders desk reference that you would only use the above dx codes if there was absence of a symptom. I have also been told that we should be using v72.40 for every HCG test as these test are not fully accurate and most generally the provider will request a venipucture to have a confirmed dx of pregnancy.
I feel that the HCG is a test and we would be ok using v72.41 if test result is negative and v72.42 if test result is positive and if provider sends out the venipucture I would use v72.40. If the pt came in and had symptoms then I would code symptoms for the HCG test.
Can you give me your opinion on when we should and should not be using these dx codes?
Thanks for the note. In short, it is either positive or negative, period. This supports ACOG which says the “unconfirmed” option should be rarely used. In the family planning world, it is used to delay a confirmation to a third party payer or due to a need (desire) for ultrasound confirmation. However, the urine PT is pretty solid diagnostic evidence and patients either are, or are not, pregnant.