Wiki office code 99204 with v06.1 dx

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ChristineW

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We had an adult patient present to our office wanting a TDap soley because a family member in another household is having a baby. Our lead physician requires the patient to meet with one of the practitioners and be evaluated, and the practitioner will order the Tdap and the TDap will then be administered. We are currently billing 99204-25, 90718 and 90471 with dx of v06.1. The office code is being denied by the patients medical insurance because the procuedure and dx code do not match up for processing in their system. Are we billling this correctly or is there a different office code or procedure code we should be using. Any insight would be greatly appreciated.
 
I am showing that 90718 was deleted 1/1/13. See codes 90714 or 90715 - may want to check with clinical staff to see if the preservative free version is being used 90714. Our clinic uses the 90715 with V06.1 and the administration code, 90471.
 
I think you would need a diffrent dx for the office visit. Did the patient present with any problems/sympotoms? If not, you might want to consider not charging for an e/m.
 
I agree with the above posts. Based on your information provided, no E&M would be charged since they came in SOLEY for the vaccine. Code 90715 w/ dx V06.1, and 90471 w/ V06.1
 
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