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Thread: Anyone billing a nurse visit with a flu vaccine

  1. #1
    Join Date
    Apr 2007
    Mooresville, NC

    Default Anyone billing a nurse visit with a flu vaccine

    AAPC: Back to School
    I'm wondering if anyone is billing (and getting paid) a nurse visit (99201) for patients receiving the flu vaccine but not seeing the doctor?
    Carol Rosol, CPC
    Mooresville, NC

  2. #2
    Join Date
    Apr 2007
    La Crosse, WI

    Default nurse visit with flu vaccine

    Nope we are not allowed to do that for any vaccination, or injection. I work for Mayo-health system and that is their policy.

  3. #3
    Join Date
    Apr 2007
    Evansville, Indiana

    Default nurse visit with flu vaccine

    I just sat in on a webinar sponsored by our state medical association and this very situation came up. She told us that unless the nurse has significant documentation that she educated the patient on the signs/symptoms of the flu as well as the side-effects of the shot and noted some vitals on the patient or if the nurse addressed something else with some detail in addition to the shot that we could not bill a nurse visit

  4. #4
    Join Date
    Apr 2007

    Default Nurse visit with flu administration visit

    CCI Version 15.1 indicates that a "Nurse Visit" (99201, 99211) is not allowed with Flu Admin codes
    (90471, or 90473). There are no circumstances under which a modifier would be appropriate. Hope this helps.
    Last edited by dlk; 10-29-2009 at 11:50 AM.

  5. #5
    Join Date
    Apr 2007
    Columbia, MO


    First of all a 99201 can NEVER be used for a nurse only encounter. These visits must follow incident -to definition which means the physician has already seen the patient. Second you may not charge a 99211 for the patient to come in for an injection of any kind there are admin for all of these and that is the code you may charge. You know why the patient is there and there is no additional work performed other than the flu shot, vitals and nurse supervision are all components of the administration codes.

    Debra A. Mitchell, MSPH, CPC-H

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