Wiki Vaccine Administration Codes

[Lyndzee Toone]

I became a cpc-a in 2010 and spent the last 8 years studying and working on credentials. I was recently hired as an entry level coder in a family practice to do some part time internal auditing. I am still learning and need some help clearing up some confusion.

3 scenerios, Office visit 99212-99215 when coded with administration and vaccine product. Do I append modifier -25 to e/m
Procedure with administration of vaccine and vaccine product. guidelines for this?
Preventative Medicine visit with administration of vaccine and vaccine product.

I have done some research on this and found the ncci edit in 2013. AAP suggested to add -25 to e/m visits because of this, but I cant find current information.

Any help would be greatly appreciated, even references to information would be great. thanks.

 

[erjones147]

Yes, you would append the -25 onto the E/M code/Preventive Medicine code and then list the administration code and the product code

 

[Lyndzee Toone]

procedure and administration

Thank you, what about scenerio when you have procedure with administration and vaccine, ie, laceration, and tdap?

 

[KokilaVenkatesan]

No Need to add any modifier for vaccination and product rather than a laterality modifier for laceration alone is sufficient.

Thanks,
Kokila Venkatesan, CPC-A