Coding for vaccine counseling

I work in a pediatrician's office. We occasionally see patients whose parents are reluctant to immunize their children. The doctor will see them for their original purpose, whether it is a sick or well visit, and then spend a considerable amount of time counseling them on why to immunize, addressing their concerns, and seeing if he can work out any kind of schedule to get the children at least the most important shots. I have been coding the appropriate office visit, with an additional consult code of 99402 with v64.05 and v65.04 as diagnosis codes. All the insurances we have billed this way have denied the code. (Tricare and Blue Cross Blue Shield) Is there any way I can bill that additional time he spent with the family so that we can reimbursed?

Thanks for your help!

re: Coding for vaccine counseling

The 99402 is a "consultation" code for Physician consult, like if another physician requests the consult. In my experience I have found V codes DO NOT get paid without a primary dx of something else. I'm in the middle of trying to figure out how to get paid for a consult w/ no administration of vaccines. Parents scheduled the appointment and they were here for no other reason but to discuss "FUTURE" vaccinations w/ the doc.

re: Coding for vaccine counseling

Take a look at the CPT® definition for 99402, it's not a consult code.

CPT® allows us to use E/M codes based on time for discussion with the patient and/or family. Medicare requires that the patient is present. But, for non-Medicare, consider this.

It is true that some insurance companies do not allow some V codes in the first position but much less true than before.