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Thread: New Patient & Vaccine

  1. #1
    Join Date
    Apr 2007
    Honolulu Hawaii

    Default New Patient & Vaccine

    AAPC: Back to School
    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
    Join Date
    Apr 2007
    San Antonio, Texas

    Default Epsdt

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

  3. #3


    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. #4


    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. #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. #6


    yes, patient has Medicaid....

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