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New Patient & Vaccine

  1. #1
    Honolulu Hawaii
    Default New Patient & Vaccine
    Medical Coding Books
    If a provider sees a new patient and does a new patient physical exam on a 1 month old, is this considered EPSDT? If so, should the provider administer a vaccine do I code for both admin and the vaccine or just the vaccine as the administration would be included in the EPSDT?
    If it is NOT an EPSDT and the provider also administers a Hep B vaccine during the visit, should both the admin and the vaccine be coded?
    "Success is not a matter of chance; but a matter of choice. It is not a thing to be waited for, It is a thing to be acheived."

  2. #2
    Default Epsdt
    Does the patient have Medicaid?
    Diana Wilson, CPC. CPMA, CPC-I
    PMCC Instructor

  3. Default
    You would use the EPSDT only if patient has Medicaid, otherwise you do not need it. You can bill the vaccine as well with the well check. Code both the vaccine and the admin code if the service was at an outpatient office visit setting and remember if the doctor counsled the parent you can use the new admin code for this year 90460.

  4. Default
    You would only need to use the EPSDT if the patient has Medicaid. You can also code the vaccine with the office visit, both the admin and the vaccine code. Remember if the Dr. counseled the parent you can use the new admin code for this year 90460.

  5. Default EPSDT And office Visit
    Hello Team
    Can someone assist, on EPSDT and Office Visit. I know that we can bill one or the other but I was told I could bill together with a mod 25? Can someone assist?

  6. Default
    yes, patient has Medicaid....

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