I'm looking for suggestions, or advice on dx and e/m coding for a visit where a nurse was requierd by JACHO to be updated w/her immunizations. I don't know why she didn't go to employee health, but came to her primary care physician. I agree w/the level three e/m that my physician charged, he dictated a Brief Hx pres illness, explaining what was needed, and her past shots, and that this is a middle aged nurse who presents for immunziations and is otherwise well. ROS is constitutional, and documented vitals, chest clear, heart regular rate/rythm, and skin dry, no cyanoisis or clubbing,(Exp prob focused exam) MDM is straightforward, but w/2 of 3, I agree w/99213. My problem is the dx. I come up w/V70.5, as this was requested by work, but I doubt that BSRI will pay w/the V code. We did administer Adacel, and placed the first of a two series PPD. So, I was going to bill 99213/25 V70.5, V06.1, V74.1, 90471 (v061), and 86580 (V74.1) any other thoughts/suggestions?