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ADMIN VACCINE WITH A 'WELLNESS VISIT'

Pam Posted Thu 30th of October, 2014 18:01:30 PM

WE ARE TRYING TO BILL 99385 (WELLNESS EXAM) AND WHILE PT. IS HERE WE ARE ADMIN'VACCINE 96372, we are getting rejected by cigna and other insurances.

can you help with what are we doing wrong?

SuperCoder Answered Fri 31st of October, 2014 07:35:15 AM

Thank you for your question.

Can you provide the denial reason? This will allow us to further research.

Pam Posted Mon 10th of November, 2014 16:50:52 PM

denying for bundling - saying the wellness is being bundled to the admin of vaccine

SuperCoder Answered Tue 11th of November, 2014 07:39:28 AM

Thank you.

If you are administering a vaccine/immunization, you would want to use code 90471.

90471:Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections); 1 vaccine (single or combination vaccine/toxoid)

See note for 96372: Therapeutic, prophylactic, or diagnostic injection (specify substance or drug); subcutaneous or intramuscular
Notes:
(For administration of vaccines/toxoids, see 90471, 90472, 96365, 96366)

https://www.supercoder.com/cpt-codes/96372

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