istanstu
Networker
My practice has begun a new practice of requiring an office em(99212-99213) visit to be performed and billed for any patient receiving a vaccine. The chart has for example exam components. Cc of here for HPV vaccine and the diagnosis is always just the particular need for vaccination code ( v0489?) We also bill the vaccine CPR and the admin code of either 90471 Or 90460
I have stated that by appending a 25 modifier to the em we are bypassing claim edits and telling the payer to reimburse us for Em even though it isn't justified medically necessary. Has anyone else experienced this issue. Am I misunderstanding the Use of 25 mod. These specific examples are strictly to bring patient into office to receive vaccine but the new policy is requiring provider to document and perform an em service. Any suggestions
I have stated that by appending a 25 modifier to the em we are bypassing claim edits and telling the payer to reimburse us for Em even though it isn't justified medically necessary. Has anyone else experienced this issue. Am I misunderstanding the Use of 25 mod. These specific examples are strictly to bring patient into office to receive vaccine but the new policy is requiring provider to document and perform an em service. Any suggestions