Go Back   AAPC Medical Coding & Billing Forums > Medical Coding > General Discussion
Forum Rules FAQ Members List Calendar Search Today's Posts Mark Forums Read

Reply
 
Thread Tools
  #1  
Old 08-06-2008, 09:50 AM
JCampbell JCampbell is offline
Guru
 
Join Date: Apr 2007
Posts: 142
JCampbell is on a distinguished road
Thumbs up Well Child Visit & Immunizations

--------------------------------------------------------------------------------

Can someone tell me if childhood immunizations are included in a well child visit or if they are paid seperately? I thought they would be paid seperately but want to make sure. Also would you bill the drug, admin fee and well child visit? Or would you just bill the drug and well child visit?
Thanks!
Reply With Quote
  #2  
Old 08-06-2008, 10:06 AM
jvirgin jvirgin is offline
New
 
Join Date: Apr 2007
Posts: 1
jvirgin is on a distinguished road
Default Child visit and Immunizations

As far as I know from working in PEDS. The Immunizations are billed separating. Depending on the type of Insurance is the actually cost of the immunization.
Reply With Quote
  #3  
Old 08-06-2008, 10:14 AM
dmaec's Avatar
dmaec dmaec is offline
True Blue
 
Join Date: Apr 2007
Location: Duluth, Minnesota
Posts: 1,134
dmaec is on a distinguished road
Default

you can bill the immunizations separately - append a modifier .25 to the preventive service office visit. Yes, you charge the administration fee also - 90471 for the initial immunization given and 90472 for any others (depending on how many are given). Some insurances do not pay for the immunization as the suppoly is given by the State and considered "free", for - Medical Assistance and PMAP program immunizations are "free", we have to append the .SL modifier to them. We are reimbursed for the adminstration of them.
{that's my opinion/advice on the posted matter}
__________________
Donna, CPC, CPC-H
Reply With Quote
  #4  
Old 08-06-2008, 10:17 AM
AllisonH AllisonH is offline
New
 
Join Date: Apr 2007
Posts: 4
AllisonH is on a distinguished road
Default

You bill the well child visit, the drug administered and the admin. fee....depending upon the number of immun. admin. you use the add on code for additional immun. Don't forget to see if the drug was administered orally or intramuscular there are separate ones for that.


Allison Hudson, CPC
Reply With Quote
  #5  
Old 08-06-2008, 11:28 AM
kbarron kbarron is offline
True Blue
 
Join Date: Apr 2007
Location: Seacoast- Dover New Hampshire
Posts: 598
kbarron is on a distinguished road
Default

Quote:
Originally Posted by AllisonH View Post
You bill the well child visit, the drug administered and the admin. fee....depending upon the number of immun. admin. you use the add on code for additional immun. Don't forget to see if the drug was administered orally or intramuscular there are separate ones for that.


Allison Hudson, CPC
Don't forget if they are under 8 to use 90465/90466 if counseling was done.
__________________
Karen Barron, CPC
Hampton New Hampshire Chapter

Last edited by kbarron; 08-06-2008 at 11:29 AM. Reason: add wording
Reply With Quote
  #6  
Old 08-06-2008, 01:16 PM
Lisa Bledsoe Lisa Bledsoe is offline
True Blue
 
Join Date: Apr 2007
Location: Greeley, Colorado
Posts: 2,043
Lisa Bledsoe is on a distinguished road
Default

If an oral/intranasal immunization is done in conjunction with IM, be sure to use 90474 (as subsequent to the initial 90471).

kbarron - Aren't the counseling immunizatino administration codes only used if there is not a WCC? Because "counseling" is part of the preventive code? Just curious how others view these counseling codes...
Reply With Quote
  #7  
Old 08-06-2008, 01:26 PM
kbarron kbarron is offline
True Blue
 
Join Date: Apr 2007
Location: Seacoast- Dover New Hampshire
Posts: 598
kbarron is on a distinguished road
Default Immunizations

[quote=Lisa Curtis;20804]If an oral/intranasal immunization is done in conjunction with IM, be sure to use 90474 (as subsequent to the initial 90471).

kbarron - Aren't the counseling immunizatino administration codes only used if there is not a WCC? Because "counseling" is part of the preventive code? Just curious how others view these counseling codes... [/QUOTE

Lisa:My understanding is that vaccine codes are separate from the WCC, and when done at the WCC, can use 90465/90466...Look forward to the buzz about this topic...
__________________
Karen Barron, CPC
Hampton New Hampshire Chapter
Reply With Quote
  #8  
Old 08-07-2008, 02:07 PM
Lisa Bledsoe Lisa Bledsoe is offline
True Blue
 
Join Date: Apr 2007
Location: Greeley, Colorado
Posts: 2,043
Lisa Bledsoe is on a distinguished road
Default

Karen -
Here's my thought process: Preventive Med codes include "counseling/anticipatory guidance/risk factor reduction intervention"; code 90465-90468 are reported "only when the physician provides face-to-face counseling of the patient and family during the administration of a vaccine." Seems like using both might be double dipping into the counseling...just my opinion.
Reply With Quote
Reply

Thread Tools

Posting Rules
You may not post new threads
You may not post replies
You may not post attachments
You may not edit your posts

BB code is On
Smilies are On
[IMG] code is On
HTML code is Off




Disclaimer: Although AAPC staff members will monitor these forums periodically, we cannot be responsible for the information posted herein, nor guarantee its accuracy. Our members may discuss various subjects related to medical coding, but none of the information should replace the independent judgment of a physician for any given health issue. Please note that the opinions expressed here do not necessarily reflect those of AAPC.

All times are GMT -6. The time now is 08:17 PM.

AAPC - Top

Powered by vBulletin® Version 3.8.1
Copyright ©2000 - 2014, Jelsoft Enterprises Ltd.
Copyright ©2014, AAPC