How do you code a flu shot for Medicare?
Administration services for these preventive vaccines are reported to Medicare using HCPCS codes as follows: G0008 administration of influenza virus vaccine.
How do you bill G0008 and 90471 together?
For vaccines given the same day as a G-Code vaccine, use 90471. For example, if a patient receives a flu shot and tetanus shot, you would bill G0008 for the flu vaccine and 90471 for the tetanus vaccine; also add modifier 59 (distinct procedural service) to the G code.
What is the CPT code for administration of the flu vaccine?
Use the CPT code for the vaccine administered (90685) and link to the diagnosis code for the immunization. Because qualified counseling occurred for a patient younger than 18 years of age, bill 1 unit of 90460 for administering influenza vaccine. Link to the immunization diagnosis code.
Can we bill CPT 90471 to Medicare?
You would have to use 90471 because G0008 is not a primary code for 90472. Also remember, Medicare doesn't pay for vaccinations outside of the flu, pneomoccocal and HepB. They will pay for tetanus if there is a medical reason for it, but not just a preventative vaccination.
Does Medicare pay for CPT code G0008?
Use separate administration codes for the seasonal influenza virus (G0008) and pneumococcal (G0009) vaccines. Medicare pays both administration fees if a beneficiary gets both the seasonal influenza virus and the pneumococcal vaccines on the same day.
Does G0008 need a modifier?
A modifier is not required. For example: Non-Medicare patient: 90658, 90732, 90471, 90472, 99213; Medicare patient: 90658, 90732, G0008, G0009, 99213.
How do you code a 2021 flu shot?
90688=Inactivated Influenza Vaccine, quadrivalent (IIV4), split virus, 0.5-mL dosage, for intramuscular use. Source: 2021 CPT.
What is the Medicare code for 90471?
90471 One vaccine, single or combination vaccine/toxoid. Immunization administration (includes percutaneous, intradermal, subcutaneous or intramuscular injections).
How do you bill office visit and flu shot?
Coding: Bill with 90471 only (If another vaccine is given at the same visit, code the administration fee for the second injection with 90472.) When billing for multiple vaccine administrations, you can either report administration add-on codes per line or report as multiple units on one line.
What is the difference between 90471 and 90472?
To report three intramuscular injections, report 90471 for the initial intramuscular vaccination administration and 90472 x 2 for the additional intramuscular administrations.
What is the difference between 90460 and 90471?
The 90460 code is used when a physician is present and performs face-to-face counseling to the caregiver or parent. This code can only be used for patients through age 18. Code 90471 is used when the drug is administrated by a medical assistant or nurse and the patient does not see the physician at all.
What is a GY modifier used for?
GY Modifier: This modifier is used to obtain a denial on a non-covered service. Use this modifier to notify Medicare that you know this service is excluded.