Pediatric Coding Alert

Question: A new patient presented for a flu shot only, but the doctor had to at least review the patient’s records to check for an egg allergy, etc., before administering the vaccine. Should we bill the Z23 diagnosis with a sick visit (99202-99205) along with the flu vaccine and counseling administration code 90460?

Codify Subscriber

Answer: You should report 90460 (Immunization administration through 18 years of age via any route of administration, with counseling by physician or other qualified health care professional; first or only component of each vaccine or toxoid administered) along with 99401-25 (Preventive medicine counseling and/or risk factor reduction intervention(s) provided to an individual [separate procedure]; approximately 15 minutes, Significant, separately identifiable evaluation and management service by the same physician or other qualified health care professional on the same day of the procedure or other service).

There is no need for a sick visit code, since the codes you’re already reporting cover the time the pediatrician spent asking the patient about her background, allergies and other issues.