Modifier on flu vaccine administration 90471

Here in NY we are having some slight problems with an Office Visit the Same Day as the Flu Vaccine and Administration. Blue Cross wants a 59 on the admin code 90471 but Medicare wants a 25 on the Office visit with their Admin of G0008. And a local carrier EBS Rmsco denied our office visit when the 59 was on the admin 90471.
I was wondering if anyone else out there was having these difficulties.

Thank you