Friday, July 13, 2012

DX code for Pap smear, Proctosigmoidoscopy and regular immunizations

Pap smears V72.3  V76.2

Annually for women over age 18 (younger if sexually active) until three consecutive satisfactory normal annual examinations. Frequency may then be less often at the discretion of the patient and clinician but not less frequently than every three years. No PCM or TriWest referral or
copayment are required for TRICARE Prime beneficiaries who use network providers.

Proctosigmoidoscopy/ sigmoidoscopy V70.5 V70.9

Individuals at average risk for colon cancer:

Proctosigmoidoscopy/sigmoidoscopy once every three to five years beginning at age 50.
Individuals at increased risk for colon cancer:

Proctosigmoidoscopy/sigmoidoscopy once every five years, beginning at age 40, for individuals with a first-degree relative diagnosed with a colorectal cancer or an adenomatous polyp at age 60 or older, or two second-degree relatives. Individuals at high risk for colon cancer:

Annual flexible sigmoidoscopy, beginning at age 10 through 12, for individuals with known or suspected familial adenomatous polyposis.

Regular immunizations V20.2 (includes well-child check)

Immunizations should be administered at age-appropriate doses as suggested by the current schedule of recommended vaccines for use in the United States by the Centers for Disease Control and Prevention
(CDC) Advisory Committee on Immunization Practices at Note: Immunizations recommended specifically for travel outside the United States are not covered, except for immunizations required for ADFMs whose sponsors have permanent change-of-station orders to overseas locations, which are covered as outpatient office visits.

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