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G0009 and 90471?

mtrandel

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How do you code the immunization administration for a Medicare patient when they receive both a pneumonia (or flu) shot in addition to another vaccine such as a tetanus shot? We first tried billing G0009 and 90471 but got a denial. I then read to try G0009 and 90471 mod. 59 but Medicare only paid for the 90471 and denied the G0009. Will they only pay for one admin.? Thanks.
 

dmaec

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the denial was probably because you have two "initial" administration codes - the pneumovax vaccine admin is the G0009 (which is equal to the 90471), so added immunizations that don't require a G-code administration code should then be the 90472 :)
at least that's what worked for us in the past
 
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