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*1. What are V codes?* V codes (codes V01 V86) are used to describe encounters when a specific disease or injury (codes 001 999) does not describe the diagnosis or problem. V codes are used either as a first listed (primary) or secondary code depending on the situation. There are four primary situations that V codes are used for: 1. When a person who is not currently sick or injured who encounters the healthcare system for a specific reason(e.g. exposure to an infectious disease) 2. When a person with resolving injury/disease or a chronic condition requires aftercare for that condition (e.g. suture removal, dressing change) 3. In circumstances that influence a person's health status, but are not themselves a current illness or injury (e.g. asymptomatic HIV status) 4. Newborns, to indicate birth status

*2. Can V codes be used as a primary diagnosis?* Yes, some V codes can circumstances. These encounter for testing diagnosis code can be be used as a primary diagnosis in certain codes may be used as a primary code to explain an or examination, particularly when no other used.

Example: A patient comes to the ED after finding a bat in the tent while camping. There is no obvious injury. In this case the primary diagnosis would be V01.5 Contact with or exposure to rabies. Some V codes are designated as "secondary diagnosis only." Examples of V codes that may not be assigned as a primary diagnosis include V15.81 (non-compliance with medical treatment), V15.85 (exposure to potentially hazardous body fluids), and V22.2 (pregnant state, incidental).

*3. Are V codes mandatory?* Use of V codes is not mandatory, but they should be used when they explain an encounter for testing or to identify a potential risk. They should not be used, however, when the diagnosis code includes the information provided by the status/V code. Example: A patient with a ventricular-peritoneal shunt present to the ED with a vomiting. After an appropriate evaluation it is determined that there is no shunt malfunction and that the vomiting was most likely due to a viral process. In this case the primary diagnosis would be 787.03 Vomiting. A secondary diagnosis of V45.2, presence of cerebrospinal fluid drainage device, would help explain any workup to determine if there was a shunt malfunction. Example: A patient with a heart transplant present with complications

associated with the transplant. 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 quoting from ICD-9-CM, section 1.C.18.d.3

*4. What are some commonly used V codes in Emergency Medicine?* The following are some commonly used V codes in the ED and the situations in which they may be used. 1. V71.4 Observation following other accident a patient presenting after a motor vehicle accident but is uninjured 2. V71.5 Observation following alleged rape or seduction examination of either the victim or culprit for evidence collection 3. V70.4 Examination for medicolegal reason - patient brought by law enforcement for blood-alcohol test. 4. V55.1 Attention to artificial openings, gastrostomy a patient is sent from nursing home because G-tube has fallen out and needs replacing 5. V62.84 Suicidal ideation - patient is having suicidal thoughts or actions. 6. V22.2 7. V65.5 8. V71.3 9. V71.89 Observation for other suspected conditions 10. V72.41 Negative pregnancy test 11. V72.42 Positive pregnancy test 12. V15.81 Non-compliance with medical treatment (not primary Dx) 13. V15.85 Exposure to potentially hazardous body fluids (not primary Dx) 14. V58.31 Encounter for change or removal of surgical wound dressing 15. V58.32 Encounter for removal of sutures Observation following accident at work Person with feared complaint not found Incidental pregnancy (not primary Dx)

*5. What are E codes?* E codes are supplemental codes that capture the external cause of injury or poisoning, the intent and the place where the event occurred. E codes are intended to provide data for injury research and prevention strategies. E codes are never to be used as a primary diagnosis code.

*6. Are E codes mandatory?* Use of E codes is generally not mandatory; however, their use may be mandatory in certain institutions and/or states.

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