Wiki How to submit claims with AW with vaccines and adding and E/M for acute visit

[cwestman]

I'm not sure how to best code for AW 99396 when the pt received flu and pneumo vaccines as preventative visit. In addition to Wellness visit the Provider also evaluated and treated acute low back pain
typically would use
99396 -25
90686
90471
90732
90471
will need to add
99212 which should also have modifier 25
Is it wrong to put the vaccines under the 99212
probably over thinking,looking for clarity
Cheri

 

[mitchellde]

You cannot use the 99212 because you are giving vaccines. You bill only the admin and the serum codes. So use the 99396 - 25, 90868, 90732, 90471, 90472. Do not bill the 90471 twice If the low back pain was a new finding by the provider then you can use the 99212 for the new finding, however if the low pack pain was a presenting complaint then you cannot address the annual and a presenting complaint at the same encounter so you can code only the annual or code only a visit for low back pain. see the excludes 1 exclusion for the Z00.0 and the Z01 codes. Also the code description states that the Z00 and Z01 codes are for visits without complaint, suspected or reported diagnosis.