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Pediatric Coding Alert

Reader Question:

Consider Options for New 'Flu Shot Only' Patients

Question: We are trying to decide how to handle new patients who want to come in just for a flu vaccine. The parent declines a well visit because it "isn't due yet" (insurance wouldn't cover an "extra" check-up), but we are not comfortable bringing in a totally new patient to just have a medical assistant do a vaccine. We want them to see a doctor for a brief visit to establish the patient, and then have the medical assistant do the vaccine. How can we collect for this? Alabama Subscriber Answer: Typically if it is a new patient, the insurance will pay for the "additional" preventive medicine visit, even if it occurs at less than a one year interval. If not, the practice will either provide a brief preventive medicine visit at no charge as a practice builder, or bill a reduced preventive medicine visit (52 modifier) which the family [...]

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