Forum - Questions & Answers
Wellcare unbunlded
Can someone please help me. I work in a pediatric practice. And every time I bill for a E&M with vaccines and admin fees the E&M is denied because they state it is unbundled?
I use the SL modifier on my vaccines at no charge.
I am in KY
Thanks
Robyn
re: WELLCARE UNBUNLDED
if you are billing for Prenventive Medicine codes 999381-99397 (age gender depends on what code) and the admin code for the Vaccine and the vaccine, you would put modifier 25 on the preventive medicine code. Also be sure to only add the DX V code for the correct Preventive Medicine code and not the V code for the Vaccine. any other E&M(99201-99215) visit needs to have a different DX attached with modifier 25, and not the DX for the vaccine, that will cause it to get denied. Good Luck:)