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Administration and E/M Visit

  1. Default Administration and E/M Visit
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    If a patient comes in for their 3 month follow up and at the time of the visit decides to receive their flu shot can we bill for the nurse admin. the drug along with the physicians service?

  2. #2
    Yes, you can bill the E/M visit along with 90471 or G0008 if Medicare and the appropriate flu vaccine code.

    Hope this helps!

    Teresa Collins, CPC

  3. Default
    Would the e/m require an modifier? I know with Medicare one is not needed.

  4. #4
    Smile E/M Modifier
    Yes, it has been our experience with Florida Medicare that modifer 25 is required on the E/M code to unbundle the administration code.

    Sheila Erwin, CPC

  5. #5
    Quote Originally Posted by JCampbell View Post
    Would the e/m require an modifier? I know with Medicare one is not needed.
    I have found that the E/M does not require a modifier when billing the immunization administration code in addition to the E/M. However, when billing the E/M and CPT 96372 when other injections are given, then the modifier 25 is required on the E/M.

    I hope this helps!

    Teresa Collins, CPC

  6. #6
    It is best to check with the payer for their rules on modifier 25 use.

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