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  #1  
Old 07-23-2008, 08:40 AM
mtrandel mtrandel is offline
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Default G0009 and 90471?

How do you code the immunization administration for a Medicare patient when they receive both a pneumonia (or flu) shot in addition to another vaccine such as a tetanus shot? We first tried billing G0009 and 90471 but got a denial. I then read to try G0009 and 90471 mod. 59 but Medicare only paid for the 90471 and denied the G0009. Will they only pay for one admin.? Thanks.
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Old 07-23-2008, 09:13 AM
Lisa Bledsoe Lisa Bledsoe is offline
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Interesting that they paid 90471 and not G0009. I would expect a denial for 90471 as I don't think Medicare generally pays for that.
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Old 07-23-2008, 10:02 AM
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dmaec dmaec is offline
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the denial was probably because you have two "initial" administration codes - the pneumovax vaccine admin is the G0009 (which is equal to the 90471), so added immunizations that don't require a G-code administration code should then be the 90472
at least that's what worked for us in the past
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Old 07-23-2008, 10:13 AM
Lisa Bledsoe Lisa Bledsoe is offline
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Excellent point Donna!!
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Old 07-23-2008, 10:29 AM
mtrandel mtrandel is offline
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Thanks! I'll give it a try.
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