I have several doctors billing flu shots with E&M that aren't supported. For instance...CC: pt here for flu shot HPI: here to obtain flu vaccine. BIB father. He is followed by another provider ABC MD. Currently in 8th grade doing well.

Full exam in my opinion for no reason. (NEED HELP WITH THIS TOO) I don't get the exam on healthy child that doesn't need.

Assessment. 314.00 ADD follow by ABC MD, discussed use of video games.
with a E&M of 99212.

I don't see where E&M is relevant to this visit
1. not a f/u visit
2. not under care of this provider
3. ADD not assessed or tx this visit.

Please help me explain to my providers that we can't just bill an E&M for no reason or without medical necessity. If there are some kind of guidelines for children that I'm not aware of please share with me. My providers keep saying..."we check all the children to make sure they are well enough for shot". Which is fine but still doesn't constitute medical necessity for visit.

Any thoughts??????

Sandi B. CPC, CPMA, CPMB