Wiki Billing question for Zoster Vaccine

[muschy]

I need help on billing a shingle vaccine. This is an AARP member w/United, the pt was seeing at the physician office. My question is should I bill for 99213, 90736 for the zoster vacc and 90471 for administration? Should I bill those code as well for the Medicare patients?..
Thanks,
Wanda

 

[jahcpc]

The Zostavax is covered under Medicare part D. Our office has an account with TransactRX which we use to bill the Zostavax to Medicare and Medicare replacement plans. The drug rep helped us set up the account. You have the correct codes however if you send the claim to directly to a Medicare or Medicare replacement plan the code with deny stating not a covered benefit.

FYI this vaccine is covered for patients who are 60 and older however BCBS covers patients who are 50 and older.

Hope this helps

 

[April1]

for a face to face with the provider, Yes you have the correct codes, as far as I know the only G codes required for medicare patients/immunizations are G0008,G0009 and G0010 the administrative fees for Influenza,Pneumo and Hep B.
Dailydata