Internal Medicine Coding Alert
Consider Payer Differences on Flu Shot Claims
PDF
Question:
Delaware Subscriber
Answer: It absolutely depends on the payer. When you choose codes for the vaccine administration, remember that coding depends on whether the patient has Medicare insurance.For private carriers, report the following codes:
• 90471 (Immunization administration [includes percutaneous, intradermal, subcutaneous, or intramuscular injections]; one vaccine [single or combination vaccine/toxoid]) for the flu shot.
• 90658 (Influenza virus vaccine, split virus, when administered to individuals 3 years of age and older, for intramuscular use) for the flu vaccine supply.
Remember Medicare G code:
When the internist provides a Medicare patient with flu vaccine, report the following:• G0008 (Administration of influenza virus vaccine) for the administration
• 90658 for the vaccine.
Internal Medicine Coding Alert
- Figure Frequency Into Your Colonoscopy Screening Coding -- or End Up With Denials
2-year rule applies to high-risk patientsIf you fail to observe frequency guidelines for Medicare screening [...] - Clip and Save:
Look to Screening LCDs for High-Risk Clues
Watch out: Medicare carriers may differ on some ICD-9 codesWhen you are coding for your [...] - Tally Your Risk the Way the Auditors Do
5 must-have answers will aid you in MDM selection You can quantify your internist's medical [...] - You Be The Coder:
Spirometry/Volume Loop Encounters
Question: The internist sees an established Medicare patient who is complaining of breathing trouble at [...] - Reader Questions:
Include V Code on Bladder Scan Claim
Question: A new patient presents to the office with complaints of abdominal cramps and pain [...] - Reader Questions:
Roll Earlier E/M Work Into Initial NF Code
Question: An established patient with benign essential hypertension reports to the internist for a checkup. [...] - Reader Questions:
Consider Payer Differences on Flu Shot Claims
Question: A 58-year-old established patient reports to the internist for a flu shot. The internist [...] - Reader Questions:
Opt for E/M on Staple Removal Encounter
Question: An established patient reported to the practice for surgical staple removal. A physician at [...] - Reader Questions:
Extra Procedure Time Could Mark Complicated I&D
Question: Would you explain the difference between a simple and complicated incision and drainage (I&D)? [...] - Reader Questions:
Confirm Internist's Role Before Coding Stress Test
Question: How should we report our internist's services when he provides interpretation and report for [...] - Reader Questions:
New Physician Doesn't Mean New Patient
Question: We have a new physician in our group whose patients from his previous group [...] - Reader Questions:
Remember Differences in CMS, CPT Consult Criteria
Question: It is my understanding that if a requesting physician asks for an opinion about [...]