Go Back   AAPC Medical Coding & Billing Forums > Medical Coding > Billing/Reimbursement
Forum Rules FAQ Members List Calendar Search Today's Posts Mark Forums Read

Reply
 
Thread Tools
  #1  
Old 10-02-2012, 10:06 AM
Daveokad Daveokad is offline
New
 
Join Date: Apr 2007
Posts: 9
Daveokad is on a distinguished road
Default Billing for Flu vaccine CPT codes?

The insurance companies keep rejecting the CPT codes for the flu vaccines I submit.

So I wanted to know what the right way was for billing for CPT codes 90655, 90656 and 90660 (which is the flumist)

Or do I always have to indicate the prophylaxis code in the ICD 9 section which is V04.81? Because I haven't exactly been doing that.
Reply With Quote
  #2  
Old 10-02-2012, 10:15 AM
mallorymartinelli mallorymartinelli is offline
New
 
Join Date: Apr 2007
Posts: 5
mallorymartinelli is on a distinguished road
Default

You must use the DX code V04.81. It specifys exact what the service was for. Have found it gets paid more quickly that way.
Reply With Quote
  #3  
Old 10-02-2012, 12:30 PM
ReginaR ReginaR is offline
Networker
 
Join Date: Apr 2007
Posts: 40
ReginaR is an unknown quantity at this point
Smile

Hi. What administration codes should I use for the flu vaccine? We use Fluvirin which is Q2037. For Medicare, I bill a G0008 but what about private pay? Should I be using 96372?

Any help is appreciated. Thank you!
Reply With Quote
  #4  
Old 10-02-2012, 12:57 PM
btadlock1's Avatar
btadlock1 btadlock1 is offline
True Blue
 
Join Date: Apr 2007
Location: Lubbock, TX
Posts: 1,505
btadlock1 will become famous soon enough
Default

Quote:
Originally Posted by ReginaR View Post
Hi. What administration codes should I use for the flu vaccine? We use Fluvirin which is Q2037. For Medicare, I bill a G0008 but what about private pay? Should I be using 96372?

Any help is appreciated. Thank you!
No - 96372 is for drug administrations (J-codes) only - Vaccine admins for commercial payers should be billed with either 90471 (when no counseling is provided, and for all patients over age 18) or 90460 for patients under 18, when counseling is provided.

Hope that helps!
__________________
Brandi Tadlock, CPC, CPC-P, CPMA, CPCO
Reply With Quote
  #5  
Old 10-02-2012, 12:58 PM
btadlock1's Avatar
btadlock1 btadlock1 is offline
True Blue
 
Join Date: Apr 2007
Location: Lubbock, TX
Posts: 1,505
btadlock1 will become famous soon enough
Default

See: http://www.aap.org/en-us/professiona...No+local+token
__________________
Brandi Tadlock, CPC, CPC-P, CPMA, CPCO
Reply With Quote
  #6  
Old 10-02-2012, 01:04 PM
Daveokad Daveokad is offline
New
 
Join Date: Apr 2007
Posts: 9
Daveokad is on a distinguished road
Default

Quote:
Originally Posted by mallorymartinelli View Post
You must use the DX code V04.81. It specifys exact what the service was for. Have found it gets paid more quickly that way.
Thank you
Reply With Quote
  #7  
Old 10-09-2012, 10:06 AM
Daveokad Daveokad is offline
New
 
Join Date: Apr 2007
Posts: 9
Daveokad is on a distinguished road
Default

Ok what about if I was billing the flu vaccine with sick visit codes? Do I still note the v04.81 code along with the sick visit codes?
Reply With Quote
Reply

Thread Tools

Posting Rules
You may not post new threads
You may not post replies
You may not post attachments
You may not edit your posts

BB code is On
Smilies are On
[IMG] code is On
HTML code is Off




Disclaimer: Although AAPC staff members will monitor these forums periodically, we cannot be responsible for the information posted herein, nor guarantee its accuracy. Our members may discuss various subjects related to medical coding, but none of the information should replace the independent judgment of a physician for any given health issue. Please note that the opinions expressed here do not necessarily reflect those of AAPC.

All times are GMT -6. The time now is 11:31 PM.

AAPC - Top

Powered by vBulletin® Version 3.8.1
Copyright ©2000 - 2014, Jelsoft Enterprises Ltd.
Copyright ©2014, AAPC