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Wiki School Based Health Immunizations

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BUTCHER129

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Morehead, KY
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We provide school based health in our area. We will provide immunizations on students that are not up to date and can't get in with their PCP. Our provider does a limited exam, due to not having seen the patient before. Can they bill for an E/M even though the only DX code is Z23? Conflicting information. Please help.
 
You cannot bill an E&M since if there is no chief complaint and you are not treating the patient for any symptom or illness. The limited exam associated with the immunization would not warrant a separate E&M service and would not support a modifier 25 in the situation you're describing.
 
thomas7331 said:
You cannot bill an E&M since if there is no chief complaint and you are not treating the patient for any symptom or illness. The limited exam associated with the immunization would not warrant a separate E&M service and would not support a modifier 25 in the situation you're describing.
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Thank you. Trying to explain this to a provider has been frustrating. I was second guessing myself.
 
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