I need help with this one....

a child came just for a flu vaccine and the physician went in the room to exam the child to make sure they were in good health to get the flu vaccine. we coded the Dx v04.81 for the flu vaccine and cpt 90465(nurse admin) and 906547. do we also bill a E&M for the physician doing an exam and if so what Dx do we use?

Nickie, CPC