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V Codes

Provider Administrative Policy

Claims Submission
Policy Date
November 2007
Revised/May 2008
Provider Type(s)
All Providers  


Our provider administrative policies contain information regarding claims submission, reimbursement, and other information in order to achieve an efficient relationship with our providers. These policies are not an authorization or explanation of benefits. Blue Cross of Idaho retains the right to add to, delete from and otherwise modify this policy in accordance with our provider contracts.


V Codes

In the ICD-9-CM manual, V codes are described as classifications of factors influencing health status and contact with health services.  There are very limited circumstances in which the V code should be used as a primary diagnosis. Only use the V codes when a more appropriate code is not available. The diagnosis must be appropriate for the procedure performed.

To apply correct benefits, some V diagnosis codes may be denied for more specific diagnoses. If a claim is denied, please review the patient’s information and send in a corrected claim with a more specific diagnosis code. Please follow PAP206  when submitting corrected claims.

If a claim is for a follow-up V diagnosis code and there is no other diagnosis, indicate the reason for the follow-up in the narrative field of your claim form.
Example: follow-up to a previous ear infection; or follow-up to spinal injury due to an accident (include the accident date if it is not already on the claim).

If Blue Cross of Idaho denied or returned a claim(s) and the office believes it is the only diagnosis appropriate, please submit medical records with the claim to:

Blue Cross of Idaho
Attention: Provider Appeals Unit
P.O. Box 7408
Boise Idaho 83707
Please mark your envelope “Confidential

Policy History

Date Action Reason
May 2008 Revised Language clarification

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