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Charging Flu Shot And Nurse Visit

  1. #1
    Exclamation Charging Flu Shot And Nurse Visit
    Medical Coding Books
    It's flu season again and the annual discussion of whether to charge for a nurse visit. I need documentation on this issue. Can we charge a nurse visit for each patient when they come in for a flu shot? More importantly is it payable? Does anyone else charge this way?

  2. #2
    Louisville, KY
    CMS has made this issue explicitely clear. I do not have a link to provide you, but trust the statement has been made:

    When patients present for Flu shots (only), then the charges should reflect those services (administration/vaccine code/HCPCs).

    To my knowledge, that has not changed. Look at it this way, the nurse is doing nothing in addition to administering that vaccine. With that being the case, it's hard to argue a 99211 as appropriate.

    Of course, as with every aspect of coding, some payers may have requirements unique to their members. Let that--upon written support--guide your code selection also.

    I'm sure that searching the CMS website will yield a specific directive.

    Good luck to you.

  3. #3
    Rhonda Buckholtz, CPC, CPC-I, CGSC, COBGC, CEPDC, CENTC
    Vice President, ICD-10
    800-626-2633 ext 183
    Fax: 814-217-0447

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