Wiki FLU BOOSTER

[sgaskill]

Children under 6 months old get a flu booster. how do you get reimbursed for the booster? I have billed 90688 with 90471 for the first shot 4 weeks later child comes back for the booster. According to the nurse she gives .5 ml the first time then second visit she administers the other .5. Some coders say to post 90688 with 90471 once and do not bill for the booster. I can see that if you are giving .25 then the other .25 when baby comes back in 4 weeks but how do you get reinburse for the second .5? and if nurse is giving the full .5 why do everyone calls it a HALF dose?

 

[vanessamoldovan]

Children under 6 months old get a flu booster. how do you get reimbursed for the booster? I have billed 90688 with 90471 for the first shot 4 weeks later child comes back for the booster. According to the nurse she gives .5 ml the first time then second visit she administers the other .5. Some coders say to post 90688 with 90471 once and do not bill for the booster. I can see that if you are giving .25 then the other .25 when baby comes back in 4 weeks but how do you get reinburse for the second .5? and if nurse is giving the full .5 why do everyone calls it a HALF dose?

Please see attached reference sheet from the American Academy of Pediatrics regarding immunizations. Hope this helps.

 

[sgaskill]

Please see attached reference sheet from the American Academy of Pediatrics regarding immunizations. Hope this helps.

I do understand the billing for the flu shot what my question is why insurance will not pay for the BOOSTER. Nurse is NOT giving a .25(90687) she is giving the full .5 dose for first shot under 6 months old and then she give the second .5 second visit. when I bill I bill the full dose 90688 with a 90471 or 90460 depending if Dr is involved. The questions is how to bill for BOOSTER .5 for the second time to insurance and not be denied as a duplicate. Now remember .25 (90687)is not the administered amount of the flu on either visit the shot is .5 both times.