Flu Vaccines -- Not H1N1

I am looking for coding clarification regarding when patients recieves both the Influenza Virus vaccine and Pneumococcal Pneumonia Virus (PPV) vaccines during the same visit. Does the V06.6 get attached to all codes (90471, 90472, 90658 and 90732)? Or should V04.81 be attached to the Influenza Virus vaccine and adminstration, and V03.82 on the PPV and administration? Also, what is the correct way to code the E&M?

many answers

1- there is no E&M with a visit for a flu shot only, not even a 99211. If the patient is seen for other issues then you can bill the E&M appropriate for those issues.

2- link v04.81 to flu shot and 90471 and V03.82 to 90472 and pneumovax (or 90471 to pneumovax and 90472 to flu - it does not matter)

3- Ignore V06.6- just risks a denial IMHO. Never used it, never needed it.