Wiki V70.0 - Our physicians evaluate

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KGETGEN

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Our physicians evaluate our pediatric patients prior to giving them a vaccine. Most of the time we do this to catch up a patient on vaccines whom has already had a preventative visit; administering Gardasil vaccines; TdaP vaccines at age 11; or parents prefer to only give 1 vaccine at a time.

We will code an E/M (99212) with dx V70.0. Is this ok to do?

Some of our payers reject the payment for the E/M code and some of our payers will pay for the E/M. Any suggestions???
 
Unless the physician is performing an exam to support the code I would not bill those codes. I also code for a pediatrician and if the pt only comes in for the vaccine even if the doctor stops in to say hello and make sure there are no new problems we only bill for the vaccine.
 
Our physicians do the exam and then order the vaccine. I just wasn't sure if there was a better dx code to use.
 
Hello,

If the patient is under the age of 18 you could also use-
V20.31 (under 8 days old)
V20.32 (8-28 days old) or
V20.2 (28 days and older; up to 17)

if you need to capture the actual vaccines, you could use the dx that is associated.
TDAP- V06.1
HEP A/or B- V05.3
Pneumococcal- V03.82
-just to name a few

If the provider offered any type of counseling along with the office visit you could use the counseling code- 90460/90461 and append a -25 modifer to the 99212. The immunization counseling code would be on the professional side, not sure how you bill, we have it set up to bill a professional /tech-facility charge.

Hope this helps and is not too confusing.. let me know if you need any additional info
Julie
 
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