# Vaccination Injection Codes With Office Visit



## SCPage (Jan 16, 2013)

Since the first of the year I am encountering a new CCI edit in our EHR system (Epic). The edit is rejecting the use of injection codes (such as 90471 or 90472) with standard E/M visit codes (99213, etc.). I've always appended modifier 25 to the office visit when billing a therapeutic injection administration (96372), but never when billing 90471 or 90472 for vaccinations. I tried appending -25 to the office visit to see if it would clear the error, but it didn't. I've tried to find information from Medicare about the correct use of modifiers when billing vaccinations and/or to see if there is a new CCI edit, but I've had no luck. Does anyone have any suggestions or know where I can get information regarding the correct use of modifiers when billing vaccinations? Thanks!


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## AMBIRAD (Jan 16, 2013)

*Vaccine administration codes*

You must apply a 25 modifier to the E&M code, provided a separate E & M was done.  This information is in the CPT book under Immunization administration.


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## kari2007 (Jan 21, 2013)

I've encountered the same edit in Epic. i checked the CCI edits and it is a new addition this year. It does indicate you can bypass the edit with a modifier. However i have not found anything yet to tell me when it would be appopriate to bypass it.


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