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Wiki Immunizations for work

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MICHELLE1279

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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?
 
It is federal law that her employer supply this. If she chose to go to her primary care provider, in all likelihood, its going to be denied and she will end up paying out of pocket for it herself. (provided her PCP is not affiliated with her employer)
 
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