If the visit is specifically for Wellness...you should be using the proper E/M code for wellness, no modifier needed. Vaccines are billed with the appropiate administration codes w/ the vaccine (90471, 90472)...if the child has a seperate, identifiable illness...maybe a cough or runny nose, if addressed and treated, then a modifier-25 would be added to a E/M office visit 99212/99213...etc. etc.with the age appropiate wellness code too for seperate payment on each.
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