Wiki Medicaid billing

[mckaya]

Physicians has not seen the patient in over a year.
Mother calls and schedule vaccine/immunization visit.
Since the physician has not seen the patient in over a year he does a face to face and exam and bills an office E/M with administrating the vaccine?
Can someone direct me to what would be the appropriate diagnosis. The insurance company is not paying the E/M with diagnosis Z23.

Thanks

 

[erjones147]

Do you have enough documentation to code a Z00.129 as primary dx?

 

[CodingKing]

Vaccine administration for children is inclusive of counseling so there would need to be more to support billing of the E&M, Z23 covers the vaccines only and not the E&M. Note the Code First any routine childhood examination.