# Vaccine codes and Modifier 59



## SSMcElyea-Vironet (Jun 24, 2010)

Hello everyone!  In need of help ASAP!

99214   - Est. Level 4
90746   - Hep B
90471   - Admin >8 yrs old
90632   - Hep A
90472-59   - Add-on

Anthem paid the office visit but not the vaccines and admins.  This is how it was originally billed.  Now if I'm not mistakened, the add-on code 90472 doesn't need a modifier does it? 

I need clarification!  Thanks!

Sarah Mc.


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## mitchellde (Jun 24, 2010)

that is correct the first 90472 does not need any modifier.


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## hpatzke (Jun 24, 2010)

that is correct, 90472 does not warrent the use of any modifiers as it cannot be billed without a primary procedure being billed.  The primary procedure for 90472 can be billed with any initial immunization cpt code.


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## poxleitner (Jun 26, 2010)

All of the payers I've ever billed to do not require any modifiers on the vaccines but do require a mod -25 on the e/m visit.


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## kat_232 (Jun 29, 2010)

I agree with regards to the addition of -25 and no -59 needed.


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