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how you code flu vaccine for medicare advantage plans

by Janis Bechtelar Sr. Published 2 years ago Updated 1 year ago
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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 correct CPT code for flu vaccine?

*90472 will only be used if another vaccine is given in addition to the flu vaccine. Providers may bill more than one unit of 90472 as appropriate....Vaccine CPT Code to ReportCPT Code Description90688Influenza virus vaccine, quadrivalent (IIV4), split virus, 0.5 mL dosage, for intramuscular use5 more rows•Aug 31, 2021

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.

Is G0008 an add on code?

Immunization Administration Add-ons The immunization administration codes 90460-90461, 90471-90474 or G0008-G0010 are reported in addition to the vaccine or toxoid code(s) 90476-90756, Q2034-Q2039. When giving more than one vaccine/toxoid, multiple administration codes are reported.

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.

What is the CPT code for flu vaccine 2021?

Payment Allowances and Effective Dates for the 2021-2022 Flu Season:CodeLabeler NameVaccine Name90662Sanofi PasteurFluzone High-Dose Quadrivalent (2021/2022)90672MedImmuneFluMist Quadrivalent (2021/2022)90674SeqirusFlucelvax Quadrivalent (2021/2022) (Pres Free)90682Sanofi PasteurFlublok Quadrivalent (2021/2022)6 more rows•Dec 22, 2021

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.

How do you code vaccine administration?

For immunization administration other than COVID-19, codes 90460–90474 are reported for the administration of the vaccine, along with the appropriate vaccine/toxoid code (90476–90756) targeting the organism.

What is procedure code G0008?

Influenza HCPCSHCPCS / CPTDescriptionG0008Administration of influenza virus vaccine (allowable same as90653Influenza virus vaccine, inactivated, subunit, adjuvanted, for intramuscular use10 more rows•Oct 13, 2021

How do you bill flu vaccine and administration?

If you administer an injection of the influenza vaccine only, report 90471. If you administer an influenza vaccine in addition to other vaccines, report the influenza injection with 90472. Note that code 90471 or 90473 cannot be reported in conjunction with 90460.

Does Medicare reimburse G0008?

Effective March 1, 2003 HCPCS codes G0008, G0009, And G0010 should be reimbursed at the same rate as HCPCS code 9047.

What modifier can be used with 90471?

If 90471 does not represent a duplicate of the service described by HCPCS code, modifier 59 may be to the 90471 code. In addition a diagnosis code specific to the disease for which the prophylactic vaccine is being administered, it should be linked to 90471.

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 the CPT code for quadrivalent flu vaccine 2021?

90688=Inactivated Influenza Vaccine, quadrivalent (IIV4), split virus, 0.5-mL dosage, for intramuscular use. Source: 2021 CPT.

What is the CPT code 90686?

CPT® Code 90686 in section: Influenza virus vaccine, quadrivalent.

What is the code 90471?

90471: Immunization administration for percutaneous, intra-dermal, subcutaneous or intramuscular injections, initial.

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