[Ohioaap-practicemanagers] Ohioaap-practicemanagers Digest, Vol 9, Issue 2

[Wells, Toni]

We enter the Admin code and the Vaccine code.  Some of the Managed Care Plans pay under the Admin, some the Vaccine. 

 I am "fighting" with Molina right now on the proper coding of vaccine visits. Molina is wanting us to use the 90460 or 90461, even if it is a "nurse only" visit and should be coded with 90471.  When I disputed it with our Molina Provider Rep, he told me that by the Physican "signing the encounter" we could justify the 90460. Since they only pay on the 90460, I'm not getting paid for any nurse only shot visits, right now. 


Toni Wells
Office Manger
Child Passenger Safety Technician

Hometown Pediatric Care, LLC
504 McCarty Lane
PO Box 959
Jackson, OH 45640
740-286-5455
740-286-6782 (fax)
twells at hometownpediatric.com











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From: Ohioaap-practicemanagers [mailto:ohioaap-practicemanagers-bounces at lists.deltaforce.net] On Behalf Of ohioaap-practicemanagers-request at lists.deltaforce.net
Sent: Wednesday, November 16, 2016 12:00 PM
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Subject: Ohioaap-practicemanagers Digest, Vol 9, Issue 2

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Today's Topics:

   1. Re: HPV Coding with VFC (Michael Chamberlin)


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Message: 1
Date: Wed, 16 Nov 2016 09:28:11 -0500
From: Michael Chamberlin <mikechamberlin3 at gmail.com>
To: Melanie Farkas <MFarkas at ohioaap.org>
Cc: "ohioaap-practicemanagers at lists.deltaforce.net"
	<ohioaap-practicemanagers at lists.deltaforce.net>
Subject: Re: [Ohioaap-practicemanagers] HPV Coding with VFC
Message-ID:
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We enter an admin CPT code (90460, 90471, etc) and the vaccine CPT code.
For OH Medicaid, we get paid on the admin code and for Caresource (our only managed Medicaid), we get paid on the vaccine code.

Mike

--
Michael Chamberlin, M.D., FAAP
Pediatric Assoc of Mt Carmel
4371 Ferguson Dr
CIncinnati, OH  45245
513-752-3650
513-752-3387 (fax)

On Fri, Nov 11, 2016 at 12:54 PM, Melanie Farkas via Ohioaap-practicemanagers <ohioaap-practicemanagers at lists.deltaforce.net>
wrote:

> Question from the Ohio AAP:
>
>
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> Is it true that if a patient is receiving an HPV vaccine from VFC 
> stock that the practice does NOT enter the vaccine code, they only 
> enter the administration code? How else is this vaccination documented?
>
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End of Ohioaap-practicemanagers Digest, Vol 9, Issue 2
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