tci Medicare Compliance & Reimbursement - 2016 Issue 16

Reimbursement: You Could Be Forfeiting $26,000 Annually

Always investigate denials for 90460 — here’s why. For most pediatric practices, immunization is probably the fourth most important procedure. Children need to be administered vaccines — be it during well-visits or for visits with vaccination specifically in mind. Read on to learn why not collecting for the service can cause a major dent in your practice’s bottom line. Analyses of pediatric billing patterns indicate that code 90460 (Immunization administration through 18 years of age via any route of administration, with counseling by physician or other qualified health care professional; first or only component of each vaccine...

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