E/M and Flu Shot

[dkrysl@compasshn.org]

Do I need to add a modifier (25?) to E/M code when a flu shot is given at the same visit? I am submitting claims for both Medicare and MO Medicaid.
Example:
99213 E/M
90471 flu shot administration
90656 flu shot vaccine

 

[Amy Pritchett]

E/M Modifier With Flu Vaccination

You should bill the 99213 with a 25 modifier along with the injection. But, I am confused. If you are billing for Medicare, you need the V06.6 (Need for prophylaxis), V04.81 (Influenza only) or (V03.82) as well as the G0008 or G0009 from your HCPCS book for the Medicare patient having the flu shot.
Reference:
http://www.cms.gov/Medicare/Prevention/Immunizations/index.html?redirect=/AdultImmunizations/

Hope this helps

 

[dkrysl@compasshn.org]

Thanks for your help.