Wiki -25

[Maryst]

Could someone please verify with me the use of -25 with injections or immunization when a patient comes in for an office visit for nail in the foot and in the process the physician would have to give them a tetanus shot. whould this be -25 because the shot is not the reason for the visit but a separate service or would this be looked at as a treatment option and not require a -25

 

[Lisa Bledsoe]

You would code your E/M, the vaccine admin code 90471 and the vaccine itself (depending on which product you use). You should not need mod -25 BUT some insurance carriers will require it anyway.

 

[jharrell]

I agree, we don't use -25 for vaccine shots. But we do use it for other shots that we use a 96372 with.

Jessica Harrell CPC

 

[rthames052006]

Could someone please verify with me the use of -25 with injections or immunization when a patient comes in for an office visit for nail in the foot and in the process the physician would have to give them a tetanus shot. whould this be -25 because the shot is not the reason for the visit but a separate service or would this be looked at as a treatment option and not require a -25

What I have done for this situation is called up my carriers or went to their website to get their "guidelines" and put it in a word document or excel so you have it at your fingertips... in general alot of carriers don't require it but then you have those few that do...

Good Luck