Internal Medicine Coding Alert
Q2038, G0008: Acceptable Fluzone Pairing for Medicare Patients
PDF
Question: Medicare denies our claims for flu vaccines with claim status codes of 254 and 255, which indicate problems with the principal diagnosis code. We are using Q2038 for Fluzone and G0008 for the administration, as we have done since 2011. We are also still using V04.81 as the principal (and only) diagnosis code. What is the problem?
Answer: Codes Q2038 (Influenza virus vaccine, split virus, when administered to individuals 3 years of age and older, for intramuscular use [Fluzone]) and G0008 (Administration of influenza vaccine) are valid HCPCS codes for 2013, and V04.81 (Need for prophylactic vaccination and inoculation against influenza) is an acceptable supporting diagnosis. HCPCS and CPT® have different codes for various categories of Fluzone vaccine administration. Double check the category of drug that your practitioners are administering to be sure you’re reporting the correct one. If so, you might need to follow up with your Medicare contractor to understand and correct the denial.
New York Subscriber
Internal Medicine Coding Alert
- CCI 19.1:
Injection Administration Coding Edits: New Bundling Policies
Start reporting vaccine administration with office consultation. The latest update from the Correct Coding Initiative [...] - Office Visits:
Recognize 3 Opportunities to Bill Services With Preventive Care
Tip: Check whether the payer also requires modifier 25. Preventive wellness visits are easy to [...] - Incident-To Billing:
Follow These 3 Steps for Better Incident-To Claims
Don’t forget to check your state’s laws for NPP scope of services. Having non-physician practitioners [...] - ICD-10:
Viral Infection Diagnosis: Extra Details Required to Avoid 'Unspecified' Code
Code 079.99 makes an easy switch, but payers might not reimburse. When your physician currently [...] - You Be the Coder:
Diagnosing is Important in Initial Vs. Follow-Up Fracture Visit
Question: Our physician treated a patient for a fracture of the second metatarsal. A follow-up [...] - Reader Question:
Bill 92504 Alone, Not With 69210
Question: The physician cleared cerumen impaction from the patient’s left ear and purulent drainage from [...] - Reader Question:
G0402 or G0403: Replacement Code for Deleted Code G0366
Question: A 65-year-old patient who just enrolled in Medicare came to our office for his [...] - Reader Question:
Q2038, G0008: Acceptable Fluzone Pairing for Medicare Patients
Question: Medicare denies our claims for flu vaccines with claim status codes of 254 and [...] - Reader Question:
692.6 for Poison Ivy Diagnosis
Question: I’m having trouble finding a diagnosis code for 96372 when the physician administered two [...] - Reader Question:
Code 90714 for All TD Vaccines in U.S.
Question: I know that, as of the first of the year, code 90718 has been [...]