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G0009 and 90471?


Best answers
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.


True Blue
Hibbing, Minnesota
Best answers
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