tci Part B Insider - 2014 Issue 21

Reader Question: Watch for Flu Shot Bundles

Question: We have been receiving denials for flu vaccine codes when submitted with E/M visits and other in-office procedures. We have been using modifier 25 with these E/M codes and have also reported the flu vaccine code. What can be the rationale for these denials? Is our reporting not appropriate? Answer: You need to again check the codes that you are submitting. The Correct Coding Initiative (CCI) bundles E/M office or inpatient codes into the following vaccine administration codes:  90460 (Immunization administration through 18 years of age via any route of administration, with counseling by physician or other qualified...

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