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

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Location
Windham, ME
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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 a covid vaccine) and have tried several combinations and also splitting the vaccines into two claims. We are considering the Pfizer covid admin code (0003A) as the first vaccine and adding 90472 -59 for each subseqent vaccine (flu vaccine). We have also tried the covid admin 0003A with 90471 -59 to no avail.
 

njycarter17

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23
Location
Radcliff, KY
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We have a few offices in our primary care that gives the Pfizer vaccine. 91300 (COVID-19 Vaccine 30 mcg/0.3mL, diluent reconstituted IM) and 0003A (COVID-19 3rd dose). If the patient is receiving a booster shot of the COVID-19 Vaccine we use 0004A (COVID-19 booster dose). When patients get the flu vaccine same encounter when also getting the COVID-19 vaccine we report the Flu vaccine and 90471 or G0008 and apply modifier 59 or XU to the flu administration CPT code. I added the COVID vaccine information from the AMA that we use as a reference which was helpful for us and may be for you too. Hope it helps you out!


CPT COVID-19 Vaccine Code Descriptors
 
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