Primary Care Coding Alert

Question: When a patient comes in only to get a flu shot, should I also report an office visit (such as 99212) or should I just use 90658 and 90471?
 
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Answer: If a patient comes in "only to get a flu shot," you should report only the codes for vaccine administration (such as 90471, Immunization administration [includes percutaneous, intradermal, subcutaneous, intramuscular and jet injections]; one vaccine [single or combination vaccine/toxoid]) and the appropriate vaccine product code (for instance 90658, Influenza virus vaccine, split virus, for use in individuals 3 years of age and above, for intramuscular use).

You shouldn't report an office visit (such as 99212, Office or other outpatient visit for the evaluation and management of an established patient ...) unless you also provided a significant, separately identifiable E/M service in addition to administering the flu shot. In this case, code the office visit appended with modifier -25 (Significant, separately identifiable evaluation and management service by the same physician on the same day of the procedure or other service).