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.
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Wiki G0009 and 90471?
- Thread starter mtrandel
- Start date
Lisa Bledsoe
True Blue
Interesting that they paid 90471 and not G0009. I would expect a denial for 90471 as I don't think Medicare generally pays for that.
dmaec
True Blue
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
at least that's what worked for us in the past
Lisa Bledsoe
True Blue
Excellent point Donna!!