BCBS bunding vaccine admin

kstine713

Networker
Messages
39
Best answers
0
Our office is having an issue with BCBS bundling 90460 (vaccine administration) when performed at a visit with 17110 (wart removal.) These are completely separate services, but we have tried a 59 modifier on the 90460 to un-bundle, with no success. Does anyone have any helpful hints to getting the admin code paid?

Thank you!
 

mitchellde

True Blue
Messages
13,537
Location
Columbia, MO
Best answers
2
You cannot use the 25 on a procedure code it must be on the E&M code only. You should check the CCI edits first to see if there is a bundle edit for these two codes. If there is use the modifier XS or 59 on the column 2 code. the XS modifier is a substitute for the 59 and is payer preference. You might also investigate whether this might be a scenario for the XU modifier to indicate two services that are not ordinarily provided in the same encounter. Also watch which dx codes you link to the line items, this can cause numerous issues if the dx codes are not properly linked.
 
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