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Thread: Need help coding Immunizations

  1. #1

    Default Need help coding Immunizations

    AAPC: Back to School
    If a CPC can answer this question. It will be very helpul and appreciated.

    When giving Immunizations to a child how should the visit be coded as a regular well visit (99381-99395) or a regular E/M service (99201-99215) utilizong the ICD9 codes need for vaccines?

  2. #2
    Join Date
    Apr 2007
    Duluth, Minnesota


    it depends...why is the child coming in? is it for the "check up" and vaccinations or are they coming in because of a a problem, (sore throat, ear pain, etc),...and, oh - while here they'll get their vaccinations updated...????

    it could be either/or - depends on the intent of the visit and supporting documentation.

    if it's for vaccinations only - and they only see the nurse for a shot, and it's planned, they know their coming in and for what shots they'll be getting - that's all we code is the "shot and admin".. no office visit.

    other opinions??.....
    Donna, CPC, CPC-H

  3. #3
    Join Date
    Apr 2007
    Columbia, MO


    Donna is correct, what is the reason for the encounter, if it is to receive imunizations the code only the administration of imunization codes on office visit.

  4. #4
    Join Date
    Apr 2007

    Thumbs up immunization

    Hi please check the following egs,
    for new patient well visit:99283 - 25 - V20.2
    90471 - appropriate vaccine icd code
    for est pt well visit:99293 - 25 - v20.2
    90471 - appropriate vaccine icd code
    for new pt with sore throat 99203 - 25 - 462
    90471 - appropriate vaccine icd code
    for est pt 99213 - 25 - 462
    90471 - appropriate vaccine icd code

    after u check please reply me
    Dr.Jeevanantham Mariappan PT.,MD (A.M).,CPC.,
    Six Sigma - GB

  5. #5
    Join Date
    Apr 2007
    Baton Rouge Local Chapter


    You should only bill the well patient visit if the documentation include all the requirements of a comprehensive preventive medicine exam and if the patient has no complaints. If an illness is discovered during the provision of the preventive exam, and E/M should be coded separately appending a modifier 25. Also, don't forget to bill the administration for your vaccines!

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