HCPCS code for Zostavax ??

Orthocoderpgu

True Blue
Local Chapter Officer
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Salt Lake City, UT
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Patient came to clinic and received an IM injection of "Zosavax". I'm trying to find a code to bill this with but there is no HCPCS code listed. There does not seem to be another name that this may be listed under. Any suggestions?
 

dmaec

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Duluth, Minnesota
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do you mean Zoztavax? The immunization?
CPT 90736 (with a GY modifier for Medicare patients)
and dx code of V04.89

I've not heard of "Zosavax"
 

JWESS

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For thie shingles vaccine you bill 90736 and 90471 with the gy mod on the admin code and dx v05.4 you dont have to put any modifier on the 90736 medicare will automatically deny but you want to put it on the admin code because medicare will pay for this and they are not supposed to so you have to tell them they should not be paying for the code. Hope this helps.
Nicole wessell, bs, cpc
 

pamtienter

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NAB Member
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Mound, MN
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If it's not a Medicare patient, bill 90736 and the administration. For Medicare, the vaccine is covered under Part D. The patient could be billed for it and then they forward the bill to Part D for reimbursement. The administration isn't covered. The patient would be responsible for that charge.
 
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