FQHC Billing office visit with flu shot

smeeks31

Networker
Messages
37
Location
Omaha, NE
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0
I'm working at a FQHC clinic and I have a billing coordinator informing me that I should be billing a office visit when the nurse is giving students who come to a school clinic for flu shots. Now the flu shots are being billed to their primary insurance company (Medicaid) and I billing for the flu shot to show this service was done but she wants me to bill the office visit plus bill the T1015 code (face-to-face visit) that clinics because they are a FQHC clinic. Can someone explain to me how is this medical necessary to bill a office visit plus falsely say your doing care for a child when they are just getting a flu shot.
 

mitchellde

True Blue
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13,420
Location
Columbia, MO
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1
you cannot use the 99211 for giving the injection. the administrations codes are created to account for all of the nurses time and equipment needed to give the injection.
 

hperry10

Guru
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133
Location
Hyannis
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I work for an FQHC in Massachusetts. Massachusetts Medicaid ( Masshealth) spells out in their manual that T1015 is not to be used in place of or in addition to 90471. However we do use T1015 in place of an injection code if a nurse is giving a therapeutic or allergy injection. I encourage you to check your Medicaid billing guidelines for further information. I don't know if each state has different services that are billed under T1015 or if they all have the same rules.

Heather CPC
 
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