Can v codes be assigned as first listed or secondary diagnosis?

V codes, now known as Z codes in the ICD-10 coding system, can be assigned as either a first listed or secondary diagnosis. They are used to indicate a variety of situations, such as encounters for routine examinations, factors influencing health status, or conditions that may affect care. When used as a first listed diagnosis, they should reflect the primary reason for the encounter. However, they can also serve as secondary diagnoses to provide additional context about the patient's health status or circumstances.