# Gardasil - We have had problems



## astough (Jul 29, 2011)

We have had problems getting Gardasil paid if it is done at the same time as another service such as an annual pap smear.  Does anyone have any input on this?  Can it be billed separately on the same day as a pap or other office visit??  Does it need any modifiers??


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## btopar (Jul 29, 2011)

*Gardasil*

use modifier 25 on e/m


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## pjhancock (Jul 29, 2011)

Append 25 modifier to the preventive code for the visit.  The gardasil should be billed and paid separately - bill 90649 for the vaccine and 90471 or 90460, depending on the age of the patient and whether counseling was provided by the physician, for the admin fee, with diagnosis V04.89.


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