How do I bill Medicare with a flu shot?
You may use roster billing format, or submit individual claims using the CMS-1500 form (PDF) or the 837P electronic format. CMS systems will accept roster bills for 1 or more patients that get the same type of shot on the same date of service.
What is the administration code for flu vaccine for Medicare?
For Medicare patients, use the administration code G0008. For non-Medicare patients: If the patient receiving the influenza vaccine is 18 years of age or younger and receives counseling from a physician or other qualified health care professional (e.g., nurse practitioner), report 90460.
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.
Does CPT G0008 require a modifier?
Expert. Francynesmith said: I too was told the same thing by Medicare - G0008 must have a modifier when billed with multiple vaccines.
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 Medicare pay for CPT G0008?
Administration services for these preventive vaccines are reported to Medicare using HCPCS codes as follows: G0008 administration of influenza virus vaccine. G0009 administration of pneumococcal vaccine. G0010 administration of Hepatitis B vaccine.
Is CPT 90471 covered by 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.
What is CPT G0008?
G0008. Administration of influenza virus vaccine.
What is the Medicare code for 90471?
Report codes 90471-90474 for immunization administration of any vaccine that is not accompanied by face-to-face physician or other qualified health care professional counseling the patient and/or family, or for patients over 18 years of age.
Does Medicare pay CPT 90658?
Fluzone is billed using CPT 90658, whereas Fluzone High-Dose is billed using CPT 90662. Per the Food and Drug Administration's approved labeling, Fluzone High-Dose is only covered by Medicare for beneficiaries age 65 or older. Medicare's reimbursement is $11.37 for Fluzone, CPT 90658.
What is the CPT code for flu shot administration?
90686=Inactivated Influenza Vaccine, quadrivalent (IIV4), split virus, preservative free, 0.5-mL dosage, for intramuscular use....Coding & Reimbursement. for the 2021-2022 Season.Influenza Vaccine Product DescriptionFluzone QuadrivalentVaccine CPTa Code90687 (0.25-mL dose)90688 (0.5-mL dose)9 more rows
How do I bill CPT 90471?
For administration (ages 19 and older) of multiple vaccines on the same date, code 90471 should be used for the first vaccine and 90472 for ANY other vaccines administered on that day. One line will be billed for 90472 indicating the additional number of vaccines administered (insert 1 or 2).