Wiki Medicaid H1N1 Coding

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ddiec

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Hi,

Had anyone coding H1N1 for Medicaid yet? What CPT and ICD 9 code that you used? Is Medicaid pay? My claims got rejected as reason: invalid!!! Due to I used CPT code G9141 for injection administration. Can anyone tell me?Thank you.

Dawn:)
 
H1N1 medicaid adm

I believe that you should only be using 90470 to bill adm of H1N1 to Medicaid. The 'g' code you submitted should only be used for MEDICARE claims. Anyone can correct me if I'm wrong.
 
The G codes are definitly for Medicare, however they are designated as carrier discretion use so other carrier could use the G if they wish, sounds like your Medicaid does not wish.
 
H1N1 with Medicaid & other carriers

We are using G9142 with DX V04.81, and no administration charge for medicaid patients, for all other insurances we are using 90470 with 90663 and the DX of V04.81

Good Luck to everyone on getting paid
 
Our Medicare and Medicare replacement products require the G codes, but the rest of our payers including Medicaid will accept either G codes or CPT codes.
 
For medicaid we are doing 90663 with $.01 for the charge and 90470 for the admin. You aren't allowed to charge for the vaccine itself because its government funded. but you should get paid for the Admin. My system rejects the 90470 as a invalid code but medicaid does pay for it. also the DX code is the V04.81 as stated above. I hope that helps.
 
jod867 said:
For medicaid we are doing 90663 with $.01 for the charge and 90470 for the admin. You aren't allowed to charge for the vaccine itself because its government funded. but you should get paid for the Admin. My system rejects the 90470 as a invalid code but medicaid does pay for it. also the DX code is the V04.81 as stated above. I hope that helps.
Click to expand...


That is all correct except the dx is 488.1
 
jod867 said:
For medicaid we are doing 90663 with $.01 for the charge and 90470 for the admin. You aren't allowed to charge for the vaccine itself because its government funded. but you should get paid for the Admin. My system rejects the 90470 as a invalid code but medicaid does pay for it. also the DX code is the V04.81 as stated above. I hope that helps.
Click to expand...

THIS INFORMATION IS SOLEY CORRECT.....This is how we are billing and we are getting paid...:)
 
Everyone does realize I hope that the 90470 is a CPT code that was deleted in 1999, and the problem with the payers rejecting it as invalid is that the electronic system did not get the message that the code was revitalized on Sept 28th to be for the admin of H1N1. You will need to communicate this with some payers so they can fix the edits. This is why some get an edit for invalid code.
 
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