vaccines

  1. O

    Wiki BILLING MEDICAID VACCINES

    I am a bit confused with the billing guidelines for Florida Medicaid...See below, can anyone provide me with any guidelines that could help me....
    • OnelM2023
    • Thread
    • florida medicaid medicaid billing vaccines
    • Replies: 2
    • Forum: Pediatrics
  2. E

    Wiki Why was I marked wrong? (Practicode Case ID: OPD7203)

    The documentation: How do we know that the MCV4 0.5 mL IM vaccine refers to 90619 specifically? Also, why should we report 90461 (two units)?
  3. S

    Wiki Modifier JW

    If a patient requests a vaccine for a pediatric patient, Then the vaccine is drawn up but once taken back to the patient room the patient declines the vaccine, Can we use modifier JW to consider that waste? Has anyone seen this paid?
  4. C

    Wiki Billing/coding for covid vaccine third dose and flu vaccine at same encounter

    Hello - reaching out to see if anyone has found any specific CMS/payer guidance regarding billing for the covid vaccine and flu vaccine at the same encounter. Our practice is having trouble with Anthem processing the traditional administration codes for the flu vaccine- 90471/2 (when billed with...
  5. Y

    Wiki Prescription Drug Management - Credit For Therapeutic Injections and Vaccines?

    Hello, would a therapeutic injection or vaccination/immunization count towards the Prescription Drug Management in the MDM calculator? Thanks, Y. Trahan
  6. J

    Wiki Florida Medicaid/Medikids Vaccine Reimbursement

    Hello, I don't actually do the billing for my office but I work with the billers and we are having an issue with reimbursement on some of our vaccines. I know children on full medicaid program receive VFC vaccines and we do not get reimbursed for that but we can be reimbursed for 90460. For the...
    • jschubert
    • Thread
    • admin ahca florida medicaid medikids private vaccines title xxi vaccines vfc
    • Replies: 0
    • Forum: Pediatrics
  7. A

    Wiki 90696 for patients outside of 4-6 years old

    Hello, The nurse at our clinic who administers vaccines sometimes admins a 90696 for kids outside of the 4-6 age rage. She says it's due to patients being behind on their vaccines and circumstances like that. Can I code this a a DTaP 90700 and IPV 90713 separately? Or do I have to use the...
    • Agilbert3
    • Thread
    • audit compliance cpt family practice vaccines
    • Replies: 2
    • Forum: Pediatrics
  8. S

    Wiki Pediatric Vaccines with Flu

    Hi All, When billing pediatric vaccines, I am aware that you have to bill by component. Our clinic offers a flu shot at a discounted price for every flu season. The flu discount is cheaper than our regular administration charges. For example, let's say that our flu shot is $30 (we charge...
    • sgeorges
    • Thread
    • flu shot immunizations pediatric vaccines
    • Replies: 1
    • Forum: Pediatrics
  9. K

    Wiki What constitutes a patients medical record?

    At the clinic where I work when vaccines are given they are recorded online in a state registry but nowhere within our EMR. I have been told that the state registry is a part of the patients medical record and therefore that is sufficient documentation. But since we don't maintain that registry...
  10. K

    Wiki Vaccine Documentaion Question

    I have recently started a new job at a clinic in Washington state. At this clinic they do not document any of the shots they give to children because they document them online at the Washington state immunization registry. They say that is sufficient documentation to bill out the shots because...
  11. S

    Wiki documentation requirements for vaccines(flu)

    Hi All, Hopefully someone will be able to answer my question. What documentation is required for billing/reimbursement for a flu vaccination? Saundra
  12. S

    Wiki Foreign Travel Vaccines

    I work in a Health Dept that administers foreign travel vaccines. We currently use Z23 on all our vaccines. As usual with FT Vaccines we get a ton a insurance denials. Of course it was asked from our "uppers" that I research to see if there is another vaccine code to use for Typhoid or Yellow...
  13. G

    Wiki 90670 & 90732

    Can these both be billed (an adult in a nursing facility) ? What is the difference between them? Thank you
  14. A

    Wiki Humana Denial

    Is anyone having trouble with Humana not paying office visits, even with a mod 25 attached? These are all being denied in our office and bundled with lab services or vaccines. Does anyone have any thoughts are how to correct?
  15. J

    Wiki Billing vaccines for a fqhc

    Our clinic is a FQHC and I'm trying to find out how other clinics bill Medicare for influenza and pneumoccal vaccines. If a patient is seen for an office visit the provider will code a routine office visit (i.e. 99213) along with the codes for the vaccine and its administration code (90670...
  16. M

    Wiki Billing Coordinatior

    We continue to have questions from our physicians regarding the use of 99211,The latest situation in which the physicians would like to use this code involves vaccines and the administration codes attached, namely 90460,90461 In this situation the parents have requested a "staggered" vaccines...
  17. S

    Wiki Vaccine admin codes HELP PLEASE!!

    If a patient comes in and only sees the nurse for shots & they hand them a sheet about the vaccines, would this be enough to qualify as counseling to support using 90460 instead of 90471?
    • sluke9
    • Thread
    • 90460 90471 counseling qualify vaccines
    • Replies: 2
    • Forum: Pediatrics
  18. KHH

    Wiki Vaccines - I Am Looking For More Info

    I Am Looking For More Info On Coding Vaccines Ex:hpv,zostervax, Etc. Would Love Your Imput On Your Office Practices. We Get Some Immunization From Dhec And We Purchase Some Also. Kathy H. Hardwick- Cpc Aynor Family Practice, Aynor,sc
    • KHH
    • Thread
    • dhec immunization kathy purchase vaccines
    • Replies: 3
    • Forum: Pediatrics
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