The provider that I bill for does a lot of immigration physicals. The first visit is normally billed out as a preventive visit. It is the follow up visit that I am having a problem with. Since most health plans have limited benefits for preventive visits, we are experiencing denials when using that code for the follow up. The provider will often give an immunization at the second visit using a V code. If he codes the visit with an E/M code and uses the V code as the primary diagnois, we are getting denials as well. Any idea as to what ICD-9 I could use to avoid these types of denials? I have searched the ICD-9 book and cannot come up with anything that would work. Any help would be appreciated. Thank you.