# 87430 & 87804



## nc_coder (Mar 26, 2010)

Is anyone else having a problem getting these codes paid when done in the office?


----------



## trep72 (Mar 26, 2010)

nc_coder said:


> Is anyone else having a problem getting these codes paid when done in the office?



The way we bill 87430 depend on the insurance company.  If it is BCBS HMO/OA/POS we bill a code other than 87430.  Some other HMOs/OA/POS we bill 87880 and the others use 87430.  I will get back with you next week to give you the insurance company.  Also if we have the dx 462 we use that.

We bill 87804 as 87804-QW and 87804-59 make sure you use both.  Also use all dx given that is linked to the flu.  I hope this help.

I just started coding for a Family Practice Clinic and I'm learning a lot.

Vontressa Flournoy, CPC


----------



## nc_coder (Apr 20, 2010)

Thank you for the info.  It was very helpful.  I too am new to FP coding.  the majority of my coding career has been general surgery.  I am finding out there is a lot of differences.


----------



## BRENDA28 (Apr 21, 2010)

*87804*

@ trep72

87804,qw 87804-59  do you use this for hmo's also?


----------



## trep72 (Apr 25, 2010)

*87804*

we are now to post 87804 qw and then 87804 qw 59 this include HMO. Everyday something change.

Vontressa


----------



## BRENDA28 (Apr 26, 2010)

very good thank you for all the help Vontressa


----------



## DGELAM (Jun 26, 2013)

Do you bill mcare the 87430 and if so do you need modifer qw?



trep72 said:


> the way we bill 87430 depend on the insurance company.  If it is bcbs hmo/oa/pos we bill a code other than 87430.  Some other hmos/oa/pos we bill 87880 and the others use 87430.  I will get back with you next week to give you the insurance company.  Also if we have the dx 462 we use that.
> 
> We bill 87804 as 87804-qw and 87804-59 make sure you use both.  Also use all dx given that is linked to the flu.  I hope this help.
> 
> ...


----------



## ljamsen (Mar 12, 2019)

*87804 and 87880 on one claim*

Is anyone else billing 87804 QW, 87804-59 and 87880 on the same claim? If so, what diagnosis are you using and are all charges being paid?

linda@pediatricassociatesnc.com


----------



## angeltiara3  (Mar 14, 2019)

ljamsen said:


> is anyone else billing 87804 qw, 87804-59 and 87880 on the same claim? If so, what diagnosis are you using and are all charges being paid?
> 
> linda@pediatricassociatesnc.com



r50.9


----------

