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Flu vaccine diagnosis

  1. #1
    Default Flu vaccine diagnosis
    Medical Coding Books
    Our providers are giving the flu shot to patients that are diabetic or have heart disease. My question is would I code the diabetes first and then the code V04.81 or the other way around. If anyone has any supporting documentation that would be great. Thanks.


  2. #2
    Albany, New York
    Is the patient being seen in regards to the diabetes/ heart disease on the same day as the flu shot is given?

    If not, an office visit cannot be billed and I would use V04.81 only.

    Refer to attached website:

    Karen Maloney, CPC
    Data Quality Specialist

  3. #3
    The patient's that are receiving the flu vaccine have commercial insurance. The provider is having these patient's receive the flu shot since they have diabetes and are at a higher risk for receiving the flu. So I am wondering for the actual injection charge would I code the diabetes first since this is the reason why the provider is having the patient receive the flu injection or would I still code V04.81 as the primary diagnosis for the injection.

  4. #4
    At our clinic if the patient is only receiving a flu shot - no office visit - we code V04.81 and have no problem getting paid. Doesn't matter if they are high risk or not. If the doctor see the patient in regards to their diabetes and it is decided to give the patient a flu shot at that time then you of course would have the additional dx listed first followed by the V04.81.

    Hope this helps!!!

  5. #5
    I agree to code the vaccines with just the diagnosis code for the vaccine.
    Pam Tienter, CPC, COC, CPC-P, CCS-P, CPMA, CPC-I, AAPC Fellow
    National Advisory Board Member 2018-2021, Region 6 Great Lakes
    Minneapolis AAPC Chapter, Education Officer 2018
    AHIMA ICD-10-CM/PCS Trainer
    AAPC National ICD-10 Trainer

  6. #6
    Thanks so much!

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