# HELP!!documented in note but not listed in bill



## aimie (Oct 25, 2011)

Doctor documented vaccine performed but not listed on bill can i still say modifier 25 is necessary with e/m plus he is using a preventive code.


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## ajs (Oct 26, 2011)

Not quite understanding what you are asking...


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## aimie (Oct 27, 2011)

*sorry*

he documented he was providing immunization during preventive exam and also using e/m code with 25 modifier is it appropriate and also not listed on the encounter/bill


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## aimie (Oct 28, 2011)

*audit*

i realized after and one or two audits I do them remotely i believe it should be included in preventitive and no e/m This doctor was upcoding


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## ajs (Oct 28, 2011)

aimie said:


> i realized after and one or two audits I do them remotely i believe it should be included in preventitive and no e/m This doctor was upcoding



The immunization is not included in a preventive exam.  If it is documented in the note it should be included on the bill.  There is not an additional E/M code, it is the immunization medication and also the administration code that are used in addition to the preventive E/M.  Some carriers need a -25 modifier on the preventive exam in order to correctly process the administration of an immunization as they consider it a procedure.


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