Wiki medicaid/modifiers

[sbrown1082]

I am trying to get back the most for our injections with administration.

When baby comes in for well visit and has shots should the coding look like this

99391 - EP
90471
90669 - SL

Please help i am new to pediatric coding and could use some assistance

 

[neha.bhatnagar]

Medicaid / Modifiers

Please try following steps for coding :
1. Select age appropriate Preventive Medicine / well visit CPT code.
2. If the vaccine is supplied by State then only add SL modifier.
3. If baby is younger than 8 years use vaccine administration code 90465 for first vaccine & 90466 for each additional vaccine.
4. If baby is older than 8 years use vaccine administration code 90471 for first vaccine & 90472 for each additional vaccine.

99391 - EP - V20.2
90669 - SL - V03.82
90465 - V03.82

All The Best !
Neha Bhatnagar, CPC, CPC-H

 

[Melissa_M]

Medicaid and Modifiers

Remember that your preventive care codes 99391-99394 include the ordering of age appropriate vaccines and therefore you do not need to add the V-code for the vaccines given. This saves a lot of time and effort, instead of creating additional claims for the vaccines alone.

Hope this is helpful,

Melissa

 

[kbarron]

Melissa, Where is this in writing, not using the v code? We have a person who stated that you need to code each vaccine. I had seen this somewhere and cannot locate it. Also be carefull because some states supply vaccine for children up to their 19th birthday.

 

[RebeccaWoodward*]

Although I am in a different state than Melissa, looks like our carrier has the same guidelines.

http://www.dhhs.state.nc.us/dma/bulletin/pdfbulletin/0409SpecialBulletin.pdf

Beginning on page 25

 

[Melissa_M]

I misspoke with the preventive care; your V-codes state immunizations appropriate for age. For years we billed out 2 seperate claims with all the immunizations listed, until a couple of us attend a seminar presented by Donelle Holle, RN Coding and Remibursement Specialist. She pointed out that the V20.2 ROUTINE INFANT OR CHILD HEALTH CHECK"Developmental testing of infant or child; Immunizations appropriate for age; Initial and subsequent routine newborn check; Routine vision and hearing testing"