# e/m charge with immunizations diag



## kimb (Jun 23, 2008)

if someone came in for a tdap (v06.1) and to see the physician would you link that to the e/m 99213

ex: 99213
     90471 
     90715

401.9, v06.1

99213 diag 1 & 2
990471 diag 2
90715   Diag 2


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## racheleporterwilliams (Jun 23, 2008)

1)401.9, 2)v06.1
99213-25  1) & 2)
90471 2)
90715 2)



kimb said:


> if someone came in for a tdap (v06.1) and to see the physician would you link that to the e/m 99213
> 
> ex: 99213
> 90471
> ...


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## dmaec (Jun 23, 2008)

I'd link dx 1 -401.9 to the office visit with a .25 modifier 
99213.25
and dx 2 - V06.1 to the 90715 & 90471 only, NOT to the office visit


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## rthames052006 (Jun 23, 2008)

kimb said:


> if someone came in for a tdap (v06.1) and to see the physician would you link that to the e/m 99213
> 
> ex: 99213
> 90471
> ...



I wouldn't link dx #2 to the e/m, I'd use that for the tdap and admin only. With modifier 25 on the visit.


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## LOVE2CODE (Jun 25, 2008)

kimb said:


> if someone came in for a tdap (v06.1) and to see the physician would you link that to the e/m 99213
> 
> ex: 99213
> 90471
> ...




Where is the V05.9 (admin dx code)????????

I would code as:

1) 401.9 
2) V06.1
3) V05.9

99213-25 Dx 1,2
90715      Dx 2
90471      Dx 3


Hope this helps....

YTH, CPC


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## dmaec (Jun 26, 2008)

YTHASKINS - why would you use the V05.9? it doesn't look like an adim code to anything - it appears to me, to be a very vague dx for some unspecified disease.  They don't have a disease, they're getting a immunization-the admin code "is" the 90471 and is linked to the immunization code (V06.1 in this case) - accordingly if more than one vaccine given then 90472 x's however many and linked to the vaccine V-code.


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## Kris Cuddy (Jun 26, 2008)

Agreed, V05.9 is unnecessary. Just wondering why modifier 25 would be needed on the E/M with this? It's definitely needed if billing 90772 with an E/M, but most carriers recognize 90471 as a completely separate service. Since modifier 25 usage is always under scrutiny, perhaps bill some to your carriers without it when an immunization is given and if they don't reject you'll know it's no longer needed.

99213 - 401.9
90715 - V06.1
90471 - V06.1

Kris


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## LOVE2CODE (Jun 26, 2008)

dmaec said:


> YTHASKINS - why would you use the V05.9? it doesn't look like an adim code to anything - it appears to me, to be a very vague dx for some unspecified disease.  They don't have a disease, they're getting a immunization-the admin code "is" the 90471 and is linked to the immunization code (V06.1 in this case) - accordingly if more than one vaccine given then 90472 x's however many and linked to the vaccine V-code.




Oops.....You are absolutely correct....I stand to be corrected....

YTH, CPC


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## rthames052006 (Jun 26, 2008)

kforkismet said:


> Agreed, V05.9 is unnecessary. Just wondering why modifier 25 would be needed on the E/M with this? It's definitely needed if billing 90772 with an E/M, but most carriers recognize 90471 as a completely separate service. Since modifier 25 usage is always under scrutiny, perhaps bill some to your carriers without it when an immunization is given and if they don't reject you'll know it's no longer needed.
> 
> 99213 - 401.9
> 90715 - V06.1
> ...



Kris,

In my neck of the woods and the carriers we deal with we have to use the 25 modifier for 90471 and 90772 or else it doesn't get paid, it would be nice to not have to use it but....

I do agree with you on the cpt and dx you have listed for the procedures.


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## LOVE2CODE (Jun 27, 2008)

rthames052006 said:


> Kris,
> 
> In my neck of the woods and the carriers we deal with we have to use the 25 modifier for 90471 and 90772 or else it doesn't get paid, it would be nice to not have to use it but....
> 
> I do agree with you on the cpt and dx you have listed for the procedures.






We have to use the modifier also for most of our carriers....

YTH, CPC


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## kattekatt (Jun 27, 2008)

we have to use the modifier 25 on the E&M w/ several carriers also


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