Well Child Visit & Immunizations

JCampbell

Guru
Messages
165
Best answers
0
--------------------------------------------------------------------------------

Can someone tell me if childhood immunizations are included in a well child visit or if they are paid seperately? I thought they would be paid seperately but want to make sure. Also would you bill the drug, admin fee and well child visit? Or would you just bill the drug and well child visit?
Thanks!
 

jvirgin

Guest
Messages
1
Best answers
0
Child visit and Immunizations

As far as I know from working in PEDS. The Immunizations are billed separating. Depending on the type of Insurance is the actually cost of the immunization.
 

dmaec

True Blue
Messages
1,133
Location
Hibbing, Minnesota
Best answers
0
you can bill the immunizations separately - append a modifier .25 to the preventive service office visit. Yes, you charge the administration fee also - 90471 for the initial immunization given and 90472 for any others (depending on how many are given). Some insurances do not pay for the immunization as the suppoly is given by the State and considered "free", for - Medical Assistance and PMAP program immunizations are "free", we have to append the .SL modifier to them. We are reimbursed for the adminstration of them.
{that's my opinion/advice on the posted matter}
 

AllisonH

Guest
Messages
4
Best answers
0
You bill the well child visit, the drug administered and the admin. fee....depending upon the number of immun. admin. you use the add on code for additional immun. Don't forget to see if the drug was administered orally or intramuscular there are separate ones for that.


Allison Hudson, CPC
 

kbarron

True Blue
Messages
609
Location
Ossipee, NH
Best answers
0
You bill the well child visit, the drug administered and the admin. fee....depending upon the number of immun. admin. you use the add on code for additional immun. Don't forget to see if the drug was administered orally or intramuscular there are separate ones for that.


Allison Hudson, CPC
Don't forget if they are under 8 to use 90465/90466 if counseling was done.
 
Last edited:

Lisa Bledsoe

True Blue
Messages
2,046
Location
Greeley, Colorado
Best answers
0
If an oral/intranasal immunization is done in conjunction with IM, be sure to use 90474 (as subsequent to the initial 90471).

kbarron - Aren't the counseling immunizatino administration codes only used if there is not a WCC? Because "counseling" is part of the preventive code? Just curious how others view these counseling codes... :)
 

kbarron

True Blue
Messages
609
Location
Ossipee, NH
Best answers
0
Immunizations

If an oral/intranasal immunization is done in conjunction with IM, be sure to use 90474 (as subsequent to the initial 90471).

kbarron - Aren't the counseling immunizatino administration codes only used if there is not a WCC? Because "counseling" is part of the preventive code? Just curious how others view these counseling codes... :)[/QUOTE

Lisa:My understanding is that vaccine codes are separate from the WCC, and when done at the WCC, can use 90465/90466...Look forward to the buzz about this topic...
 

Lisa Bledsoe

True Blue
Messages
2,046
Location
Greeley, Colorado
Best answers
0
Karen -
Here's my thought process: Preventive Med codes include "counseling/anticipatory guidance/risk factor reduction intervention"; code 90465-90468 are reported "only when the physician provides face-to-face counseling of the patient and family during the administration of a vaccine." Seems like using both might be double dipping into the counseling...just my opinion. ;)
 
Top