medicare doesn't pay for wellness visit bundled with flu shot

We submitted a bill to horizon medicare. The procedures included office visit with modifier -25, subsequent wellness visit, flu shot administration, flu shot vaccine. The insurance paid for office visit and flu shot. It denied payment for wellness visit. The reason for denial is U717a: THE SERVICE IS NOT PAID SEPARATELY. THE PROCEDURE ON THIS CLAIM LINE IS MUTUALLY EXCLUSIVE TO ANOTHER PROCEDURE PERFORMED BY THE SAME PROVIDER AND FOR THE SAME DATE OF SERVICE. Is there a way to modify the claim and get paid for wellness visit?

re: medicare doesn't pay for wellness visit bundled with flu shot

What was the diagnosis for the office visit?

re: medicare doesn't pay for wellness visit bundled with flu shot

It gets tricky when billing for these. It would be better to reschedule the patient for an office visit than trying to do so many things on the same day.

re: medicare doesn't pay for wellness visit bundled with flu shot

Medicare can and does pay for an office visit in addition to an AWV and flu shot if a problem focus arises during the visit. What level E/M did you bill? I agree that the diagnosis on the E/M is most likely what's causing the issue. And the AWV should only have ICD code V70.0 for a diagnosis, which I assume you know.

For reference: http://www.acponline.org/running_practice/payment_coding/medicare/annual_wellness_visit.htm