Pediatric Coding Alert

Don't code a nurse visit at a scheduled flu shot unless you can check off 4 items. Although your nurses' time is packed with patients coming in for flu shots and added immunization visits, you've got to be resilient in reporting only allowed 99211s or you could face thousands in paybacks. That's the lesson one office learned. Two different insurance companies chart-audited the practice, which got hit with having to pay back thousands of dollars, not including lawyer fees and staff overtime. Protect your practice from being the next 99211 (Office or other outpatient visit ... Typically, 5 minutes are spent performing or supervising these services) payback statistic. Before marking the code on a claim involving immunization administration (90471-90474), make sure you can answer "Yes" to these questions. Is There a Medically Necessary Significant Reason? You should not routinely use 99211 when administering a flu shot or any other vaccine-only [...]