# Need help with denial of well visits+flu shot



## Oxana Petrenko (Apr 17, 2010)

I do collections and recently found out that Bc/Bs have denied all well check up visits if performed on the same encounter with flu shot. However, if it's done with any other(s) vaccine(s), claim is processed and paid off. Could somebody explain me if this denial is correct and why? And if it's not correct is there any additional (besides CPT guidelines) info that can help me to appeal? I appreciate you response.


----------



## kbarbag (Apr 17, 2010)

did you use a 25 modifier


----------



## Oxana Petrenko (Apr 19, 2010)

Yes, we do use modifier 25, but in this case they deny administration of vaccine such as 90471


----------



## mitchellde (Apr 19, 2010)

what dx are you linking to the 90471


----------



## halebill (Apr 20, 2010)

Keep in mind that although very minor, immunization administrations and injections _are_ procedures. You will need to protect your E/M with a 25.


Bill Hale, CPC


----------



## Oxana Petrenko (Apr 20, 2010)

Thanks everybody for your responses. We use v70.9/V20.2 for well check-ups and for flu shot and administration V04.81. Also, I got this issue fixed through provider representative. As appeared they have a system technical issue and now are working on this, so we should be fine shortly. I appreciate all of you for your help.


----------

