How to bill for Vaccination waste, parent refused?


Gilbert, AZ
Best answers
Please advise how to bill for vaccination waste?
Provider did the work of education, drawing up, and lost the vaccination, deserves reimbursement. Would be appropriate if I add modifier 53 or JW to the vaccination code?
1 Scenario; Patient came for Well visit and vaccination.
Our provider prepared the vaccination and provides face to face counseling to the family and ready to give the injection.
I would code for example;
993__ for Preventive service
99713 with 99460 X1 since it’s a single organism are considered a single component of this vaccination,

But the parent resigned it at the last minute. I have the diagnosis code for the refusal, but can we bill insurance BCBS of IL for the waste of vaccination by adding modifier 53-(stopped-discontinue procedure) or JW-(Drug amount discarded/not administrated to any patient, but JW I realized is not allowed for billing -Office setting) to procedure 99713 since it was already opened and discarded not administrated to any patient and we had to waste it, how about counseling procedure? Would be still appropriate to bill for counseling too?

2 Scenario: Same scenario for Vaccination waste but in this case patient came for Vaccination only without preventive service.

Can I submit for counseling as separate procedure using 99401 instead code 99460 since vaccination was Not administrated? (Knowing that 99401 I never bill with preventive visit on the same day)

Your help is greatly appreciated.


True Blue
Best answers
I think that billing for the provider's time in counseling is appropriate as that is reasonable and medically necessary but I would not bill for the vaccine or vaccination. JW modifier is intended for use for the remainder of a single-use vial that has to be discarded after administration. Modifier 53 is for use with surgical or diagnostic procedures. Neither of these accurately represents this situation. I understanding wanting to be compensated for the loss of the vaccine but believe it would not be appropriate to bill in this situation because the patient is not receiving any of it. If you bill it, the patient will have a record in their claims history with the vaccine code which would be incorrect and could potentially also cause a problem or denial if they came back at a later date to receive the same vaccine. A better solution would be to advise the provider that they should not be drawing up a vaccine before they have received a consent to administer it.