Wiki Vaccines vs Visit

[nramirez77]

Im having an issue with one of our Pediatric physicians charging 99212's when the child is only there for vaccines. She states that she takes vitals and goes into the room, however the nurse does the vitals and the dx she is using is V70.0. I relayed to her that to use 99212 there needs to be a problem other than just needing vaccines. This patient should have just been scheduled with nursing since there is no issue for the dr to attend to. So Im needing documentation to support this or even a tip if there is a dx where she can charge a 99212.

 

[vincil]

vaccine visit

I got this from www.aap.org. A visit just to get immunizations just doesn't meet the requirements for a 99212 according to the CPT code book's description.
Vignette #2
A five-year-old is brought in by the mother for a catch-up measles-mumps-rubella (MMR) vaccine. She
says the child is fine and has already been counseled on the vaccine and has no concerns. The nurse
proceeds to review the vaccine history, presents the VIS, and receives an order for the vaccine from the
physician. She then administers and documents the vaccine. In this situation, the service is only vaccine
related and no significant or separate E/M service is provided. Therefore, the only services reported are
the immunization administration and the vaccine product code.
The encounter would be reported as follows:
CPT ICD-9-CM
90707 (MMR vaccine) V06.4 (need for prophylactic vaccination and
inoculation against combinations of diseases;
measles-mumps-rubella [MMR])
90471 (immunization administration) V06.4 (need for prophylactic vaccination and
inoculation against combinations of diseases;
measles-mumps-rubella [MMR])