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 a serum code for 90471?

The Vaccine 90746 is the actual serum that you are using and the administration 90471 is the act of giving the injection so they are both primary with no bundleing, it is the same as a 96372 with a J code for the drug.

Is 90471 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.

When do you use 90471?

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. This code would also be used for any patient 19 years of age or older regardless if physician is present and does face-to-face counseling.

How do you bill a vaccine for counseling?

E/M visit code & vaccine counseling Of these, only two of the immunization administration codes, 90460 and 90461, include counseling by the physician or other qualified health care professional (QHP) at the time of service, specifically for patients up to and through 18 years of age.

What is the difference between 90471 and G0008?

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.

How do I bill Shingrix to Medicare?

The CPT® code for Shingrix is 90750, and of course, there is only one ICD-10 code to remember for immunizations, Z23. The patient needs two doses, separated by at least 2 months.

What is the CPT code for injection administration?

The CPT code 96372 should be used–Therapeutic, prophylactic, or diagnostic injection.

Are NDC numbers 10 or 11 digits?

It should be noted that many National Drug Code (NDC) are displayed on drug packing in a 10-digit format. Proper billing of a National Drug Code (NDC) requires an 11-digit number in a 5-4-2 format.

How do you code a SHINGRIX vaccine?

CPT Code (Product is SHINGRIX), use CPT Code 90750 – Zoster (shingles) vaccine, (HZV), recombinant, sub-unit, adjuvanted, for intramuscular injection.