Wiki Wellness visit verses Established visit

[Jashani1]

If a patient comes into the office on January 22nd for a wellness visit and receives vaccines which we billed for. The patient returns on January 29th for additional vaccines, do you code the second visit as an 99213 with an icd 10 of Z23?

 

[Chelle-Lynn]

Considering that there is only a week between visits, did the patient receive services on 01/29 that would level to a 99213? Generally if a patient is just coming back in for additional immunizations they do not receive a full E&M services.

 

[sfrasier89]

vaccines only

I had a patient come in for shots only nothing else trying to figure out exactly how to bill do I bill admin only?
I had a provider say to bill nurse code plus admin but after researching I see that is incorrect ....


Thanks in advance

 

[Chelle-Lynn]

That is correct; it would be incorrect to bill for both 99211 and 90471 per CCI edits and no modifiers are appropriate. If the patient is coming in for administration of a vaccine(s) you would bill for the immunization (ie: 90714, etc) and the administration:

90471 First vaccine
90472 each additional vaccine

or

90460 First vaccine for patient 18 years of age or younger with counseling
90461 additional vaccines for patient 18 years of age of younger with counseling.