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.
Can you bill G0008 and G0009 together?
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.
What is the Medicare reimbursement rate for influenza vaccine?
The Medicare Part B payment allowance limits for seasonal influenza (flu) vaccines are 95% of the Average Wholesale Price (AWP), as reflected in the published compendia. In hospital outpatient departments, payment is based on reasonable cost.
What is the CPT code for flu shot?
90687=Inactivated Influenza Vaccine, quadrivalent (IIV4), split virus, 0.25-mL dosage, for intramuscular use. 90688=Inactivated Influenza Vaccine, quadrivalent (IIV4), split virus, 0.5-mL dosage, for intramuscular use. Source: 2021 CPT.
Does CPT G0008 need 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 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.
What is CPT G0008?
G0008. Administration of influenza virus vaccine.
Does Medicare pay CPT 90662?
There are two flu vaccines called Fluzone: Fluzone and Fluzone High-Dose. 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.
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.
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.
Can you bill a 99211 with a flu shot?
You do not use a 99211 as there is no significant evaluation taking place. You have only what is needed for the vaccine and that is covered with the 90471. EVEN if vital signs are taken you do not charge a 99211.