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Wiki UHC Community Annual with Problem and Flu Injection

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mfioto416

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Recently we have been noticing that UHC Community has been bundling our annuals to 90471 the administration of the FLU vaccine. It occurs when we also bill for a problem visit with a 25 modifier within the same day. We thought that this was just something recent but then we noticed that UHC Community is also going as far back as October 2013 and recouping the money they paid us for these annuals.

Has this happened to anyone else? Is there a policy that has been implemented? Is there a modifier I can use to have this unbundled?

Thank you! :)
 
Vaccination administration can't be billed to any Medicaid product. If they only come in for the vaccine and meet the requirements, you could bill it with a 99211.
 
UHC Community is paying for the adminisration, they're bundling the annual into the administration where they're beginning to do takebacks on the payment for the annual. I'm not sure as to why it's occuring or if there is a modifier I can use to unbundle it.
 
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