New Patient & Vaccine

erickalm

Contributor
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Honolulu Hawaii
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If a provider sees a new patient and does a new patient physical exam on a 1 month old, is this considered EPSDT? If so, should the provider administer a vaccine do I code for both admin and the vaccine or just the vaccine as the administration would be included in the EPSDT?
If it is NOT an EPSDT and the provider also administers a Hep B vaccine during the visit, should both the admin and the vaccine be coded?
 

viola25

New
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Indian Trail, NC
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You would use the EPSDT only if patient has Medicaid, otherwise you do not need it. You can bill the vaccine as well with the well check. Code both the vaccine and the admin code if the service was at an outpatient office visit setting and remember if the doctor counsled the parent you can use the new admin code for this year 90460.
 

viola25

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Indian Trail, NC
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You would only need to use the EPSDT if the patient has Medicaid. You can also code the vaccine with the office visit, both the admin and the vaccine code. Remember if the Dr. counseled the parent you can use the new admin code for this year 90460.
 

erendo14

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EPSDT And office Visit

Hello Team
Can someone assist, on EPSDT and Office Visit. I know that we can bill one or the other but I was told I could bill together with a mod 25? Can someone assist?

:confused:
 
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