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coding question # 61

 <<Needless to say it takes MUCH longer than your
average 9 month old discussion on separation anxiety.  The child though,
was healthy.  His third hepatitis B vaccine was given.  How do you code
this?>>

I would suggest that you you charge the Well child check code than add the
appropriate evaluation and management code with the "-25" modifier
indicating  separate sick services on the same day. I would use the 4 best
diagnostic codes from the child's history to go along with the claim.

Of course, medicaid won't pay for two services on the same day, even with
the modifier, but regular insurers should honor it.

Richard Blutstein MD
Pennsboro Pediatrics
Enola, PA