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what is the type of service code for medicare billing for influenza shots

by Miss Edythe Hayes I Published 3 years ago Updated 2 years ago

HCPCS code G0008 must be used when billing Medicare for the administration of influenza vaccines, regardless of patient age or provider counseling.

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.

What is the code for influenza vaccination?

Flu Shot CodingAdministration & Diagnosis CodesVaccine Codes & Descriptors90686Influenza virus vaccine, quadrivalent (IIV4), split virus, preservative free, 0.5 mL dosage, for intramuscular use90687Influenza virus vaccine, quadrivalent (IIV4), split virus, 0.25 mL dosage, for intramuscular use25 more rows•Sep 14, 2021

What is the CPT code for Medicare flu vaccine?

Payment Allowances and Effective Dates for the 2019-2020 Flu Season:​ ​CodeLabeler NameDrug Name90662Sanofi PasteurFluzone High-Dose (2019/2020)90672MedImmuneFluMist Quadrivalent (2019/2020)90674SeqirusFlucelvax Quadrivalent (2019/2020) (Pres Free)90682Sanofi PasteurFlublok Quadrivalent (2019/2020)6 more rows•Dec 22, 2021

What is the difference between G0008 and 90471?

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.

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.

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.

How do I bill a 90471 CPT code?

To report a single intramuscular vaccination, report 90471. To report three intramuscular injections, report 90471 for the initial intramuscular vaccination administration and 90472 x 2 for the additional intramuscular administrations.

How do you code vaccine administration?

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.

What is the ICD 10 code for flu vaccine?

The ICD-10 code to use for flu vaccination is Z23, encounter for immunization. There are many CPT codes to describe influenza vaccine, varying by manufacturer, product and age group.

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