Wiki vaccine counselling

dsmith06351

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If the doctor counsels about vaccines at a physical and the parents decide to not have the vaccines done, then they schedule a nurse visit to have the vaccines done a week later can I bill the 90460/90461?

Thanks for any help

Denise Smith CPC, CEMC
 
If the doctor counsels about vaccines at a physical and the parents decide to not have the vaccines done, then they schedule a nurse visit to have the vaccines done a week later can I bill the 90460/90461?

Thanks for any help

Denise Smith CPC, CEMC

Denise, in the November 2010 AAP coding newsletter, the AAP advises "if vaccine counseling is performed and the parent or patient refuses vaccines, the time spent in counseling may be reported separately." I assume they mean report that time with the 90460-90461 codes, rather than an E/M service based on counseling time. However, I do not think that many payers will recogize separate vaccine admin codes without corresponding vaccine product codes submitted.

In your example above, it's probably best from a reimbursement standpoint to just report the admin codes at the return visit.

Hope this helps,
Jettman
 
Sorry, I don't think that I explained the scenario correctly. What I was wondering is what admin codes would I bill when the patient returned. The 90460/90461 because we counselled at the time of the visit or 90471/90472?

Thanks

Denise Smith CPC, CEMC
 
Sorry, I don't think that I explained the scenario correctly. What I was wondering is what admin codes would I bill when the patient returned. The 90460/90461 because we counselled at the time of the visit or 90471/90472?

Thanks

Denise Smith CPC, CEMC

Thanks for the clarification. If your docs didn't do face-to-face counseling at the second visit, but the vaccines were still given, report 90471/90472.
 
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