[Ohioaap-practicemanagers] OH Medicaid COVID vaccine counseling payment problem

[Michael Chamberlin]

We are still getting denials on this especially when done at a well visit.
We are being told that the 99401 can not be used at a well visit. So, does
OH Medicaid want us to counsel patients and families about the COVID
vaccine or not?  This is very frustrating.  Our rep is not helpful.  Anyone
know someone higher up at OH Medicaid or Caresource that could help explain
why this is not being paid?

Thanks,

Mike

Michael Chamberlin, M.D., FAAP
Pediatric Assoc. of Mt Carmel
4371 Ferguson Dr
Cincinnati, OH  45230
513-752-3650
513-752-3387 (fax)



On Tue, Jun 28, 2022 at 1:52 PM Michael Chamberlin <
mikechamberlinsoapm at gmail.com> wrote:

> Is anyone else using this code?
>
>
> Michael Chamberlin, M.D., FAAP
> Pediatric Assoc. of Mt Carmel
> 4371 Ferguson Dr
> Cincinnati, OH  45230
> 513-752-3650
> 513-752-3387 (fax)
>
>
>
> On Thu, Jun 23, 2022 at 2:19 PM Michael Chamberlin <
> mikechamberlinsoapm at gmail.com> wrote:
>
>> When we counsel patients about COVID vaccine and the vaccine is not given
>> at that visit, we have been billing for this counseling since early April
>> as per the release from Ohio Medicaid. However, they are not paying this.
>> We only have Caresource patients.
>>
>> We bill the 99401 cpt code with a Z71.85 (encounter for immunization
>> safety counseling) and Z28.82 (immunization not carried out due to
>> caregiver refusal).   Is anyone getting paid for this?  Which managed
>> Medicaid?  Are you using different codes than we are?
>>
>> Thanks for your help with this,
>>
>> Mike
>>
>> Michael Chamberlin, M.D., FAAP
>> Pediatric Assoc. of Mt Carmel
>> 4371 Ferguson Dr
>> Cincinnati, OH  45230
>> 513-752-3650
>> 513-752-3387 (fax)
>>
>>
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