Are you billing it as a PIC to auto insurance? If so, there would be two seperate charges as long as documentation supports it.
At our clinic, we inform the patient that if it is billing as a PIC and additional issues are brought up during that visit it could incur an additional office charge. That would be billed to the patients insurance (if any) or self pay.
If patient is using his insurance and not billing PIC - bill all together to patients personal insurance (not PIC) then again depending on documentation you charge the E/M accordingly. I would list the MVA issues 1st (main reason for being seen) and then the elevated BP and influenza shot as necessary.
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