Wiki preventative, E&M, and vaccine administration

[maggiegarner]

I have a pediatrician who is seeing a patient for a regular medical visit (99213), a yearly wellness visit (99394), and vaccines.
I put a 25 modifier on 99213, but I have 99394 denying as inclusive to the vaccine administration (90460).
I know that we can't use more than one 25 modifier, but I am not sure how to "unbundle" the preventative service from the vaccine administration.

 

[puchimee@msn.com]

Not all insurance companies pay for well visit with an E&M code. I would add modifier -25 to well visit, don't forget about putting diagnoses in the right order. 90460 should not be bundle with well visit.

I hope this helps