There are four primary circumstances for the use of V codes:
1) A person who is not currently sick encounters the health services for some specific reason, such as to act as an organ donor, to receive prophylactic care, such as inoculations or health screenings, or to receive counseling on health related issues.
2) A person with a resolving disease or injury, or a chronic, long-term condition requiring continuous care, encounters the health care system for specific aftercare of that disease or injury (e.g., dialysis for renal disease; chemotherapy for malignancy; cast change). A diagnosis/symptom code should be used whenever a current, acute, diagnosis is being treated or a sign or symptom is being studied.
3) Circumstances or problems influence a person’s health status but are not in themselves a current illness or injury.
4) Newborns, to indicate birth status
Codes V40 – V49 are for Persons with a Condition Influencing their Health Status.
• The codes in these categories are intended for use when these conditions are recorded as “diagnoses” or “problems.”
• These codes include patients with a carrier status or who have sequelae or residual of a past condition or disease, which may affect current or future treatment.
• Most of the codes in this category are secondary only diagnoses meaning that they cannot be used as the primary diagnosis.
V42.xx, V43.xx and V45.xx are also considered to be STATUS CODES: Status codes indicate that a patient is either a carrier of a disease or has the sequelae or residual of a past disease or condition. This includes such things as the presence of prosthetic or mechanical devices resulting from past treatment. A status code is informative, because the status may affect the course of treatment and its outcome. A status code is distinct from a history code. The history code indicates that the patient no longer has the condition.
A status code should not be used with a diagnosis code from one of the body system chapters, if the diagnosis code includes the information provided by the status code. For example, 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. The complication code indicates that the patient is a heart transplant patient.
V42.xx – Do not assign if patient has a complication of the transplanted organ; the code from subcategory 996.8 provides the information.
V45.61 – Use additional code for associated artificial lens status (V43.1)