# Vaccine and -25



## carmimcd (Nov 14, 2008)

Hi Everyone,

I am new to the forum and this would be my first posting. 

I was just told yesterday that modifier 25 is not needed on the E/M line when giving the influenza vaccine (any immunization) on the same day as a medical visit.

We have always used modifier 25.  I called WPS today and the person I spoke with also said no modifier was needed but she was not able to refer me to documentation other than the CCI edits.

Example:  99213 -25   401.1
              90658        V04.81
              G0008        V04.81

Carmela McDermott
McLaren Internists


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## Claudia Yoakum-Watson (Nov 15, 2008)

carmimcd said:


> Hi Everyone,
> 
> I am new to the forum and this would be my first posting.
> 
> ...



Carmela, welcome to the Forum.  This is a great place to get information from some VERY knowledgeable E/M coders.  Although I am not an E/M guru, 
I believe from a coding perspective the 25 is appropriate if a significant separate E/M was performed with the flu shot.  If I think of this a little more, I come to the conclusion that regardless of what the payer may want, it doesn't hurt to append it.  I'm interested to see what others have to say.


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## maysons1703 (Nov 16, 2008)

If the flu vaccine was administered during a preventative service, I would say no. If the patient presents for asthma f/up and the provider decides to give the patient a flu shot, then it would be appropriate to append a modifier -25 to the E/M visit. 
Melissa Freeman, CPC


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