Wiki 90471 Denial

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tmpearce

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Is there a modifier that I need to add in order to get a 90471 paid in addition to a flu shot and a pneumovax? I got this denial on the admin code even though they paid the actual flu and pneumo codes.

"This service/procedure requires that a qualifying service/procedure be received and covered. The qualifying other service/procedure has not been received/adjudicated."

Am I missing something? :confused:

Thanks,
Teresa M. Pearce, CPC
 
tmpearce said:
Is there a modifier that I need to add in order to get a 90471 paid in addition to a flu shot and a pneumovax? I got this denial on the admin code even though they paid the actual flu and pneumo codes.

"This service/procedure requires that a qualifying service/procedure be received and covered. The qualifying other service/procedure has not been received/adjudicated."

Am I missing something? :confused:

Thanks,
Teresa M. Pearce, CPC
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Did they file on the same claim? Sounds like Blue is denying this because it didn't come across with the base (vaccine) code.
 
Was this all that was billed the vaccine(s) and admin codes? If so, sounds like maybe you just need to make a call to the carrier to get the claim reprocessed.

What are all the line items on this claim?
 
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