Wiki Administration and E/M Visit

[JCampbell]

If a patient comes in for their 3 month follow up and at the time of the visit decides to receive their flu shot can we bill for the nurse admin. the drug along with the physicians service?

 

[Teresa Collins]

Yes, you can bill the E/M visit along with 90471 or G0008 if Medicare and the appropriate flu vaccine code.

Hope this helps!

Teresa Collins, CPC

 

[JCampbell]

Would the e/m require an modifier? I know with Medicare one is not needed.
Thanks

 

[armedical]

E/M Modifier

Yes, it has been our experience with Florida Medicare that modifer 25 is required on the E/M code to unbundle the administration code.

Sheila Erwin, CPC armedical@comcast.net

 

[Teresa Collins]

Would the e/m require an modifier? I know with Medicare one is not needed.
Thanks

I have found that the E/M does not require a modifier when billing the immunization administration code in addition to the E/M. However, when billing the E/M and CPT 96372 when other injections are given, then the modifier 25 is required on the E/M.

I hope this helps!

Teresa Collins, CPC

 

[ithomas14]

It is best to check with the payer for their rules on modifier 25 use.