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New Patient receiving Flu vaccine only

Bernadette Posted Thu 22nd of October, 2015 12:21:37 PM

Hi,

A new patient comes in to receive only a flu shot. The doctor needs to see the patient and at least review the records and check if egg allergy, etc. So would we bill the Z23 diagnosis with a sick visit (99202-99205) along with the flu vaccine and counseling admin code 90460? Or would 99401 with z71.89 and the flu vaccine and 90460 with Z23 be more appropriate? We appreciate your feedback.

SuperCoder Answered Fri 23rd of October, 2015 06:51:05 AM

Report it with CPT code 99401-25 and 90460 with Flu vaccine code.

Bernadette Posted Fri 23rd of October, 2015 12:18:15 PM

But what about the diagnosis? Also, we would not bill the sick code (99202-99205) with the 99401. We would only bill one or the other.

SuperCoder Answered Mon 26th of October, 2015 01:00:22 AM

Use ICD-10 code z71.89 and Z23 with 99401-25 and 90460 respectively. No, you cannot use 99202-99205 when patient just came for flu shot and related counseling.

Bernadette Posted Tue 27th of October, 2015 11:59:49 AM

Thanks - and we would still append a modifier 25to 99401 even if we are not using any other E/M code?

SuperCoder Answered Wed 28th of October, 2015 00:41:09 AM

CCI edits states "Code 99401 is a column 2 code for 90460, but a modifier is allowed in order to differentiate between the services provided." So, please append modifier -25 with CPT 99401.

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