Wiki Medicare Vaccine billing help

[suishay]

Please help!!

Medicare Patient brought in Zostavax vaccine for our nurse to administer. I sumbitted the claim with 99211, 90736 - $0, and V04.89, but the claim was on hold in our system because "If a physician sees a beneficiary for the sole purpose of administering the influenza virus vaccine, the pneumococcal vaccine, and/or the hepatitis B vaccine, they may not routinely bill for an office visit. "

Can someone help me figure out how we can bill for this? Thank you very much!!

 

[mitchellde]

you cannot bill a 99211 to administer an injection of any kind you use the injection administration code and vaccines have specific vaccine administration codes.

 

[suishay]

So this claim is not billable?

 

[mhoward@myhjc.com]

I've come across this with a different injection before. Try doing the Zostavax code for $0, and then the appropriate injection code (I'm in chiro now and can't remember what it is! ) Good luck!

 

[mitchellde]

no you will need to change the 99211 to a vaccine administration code such as 90471.

 

[eadun2000]

Please help!!

Medicare Patient brought in Zostavax vaccine for our nurse to administer. I sumbitted the claim with 99211, 90736 - $0, and V04.89, but the claim was on hold in our system because "If a physician sees a beneficiary for the sole purpose of administering the influenza virus vaccine, the pneumococcal vaccine, and/or the hepatitis B vaccine, they may not routinely bill for an office visit. "

Can someone help me figure out how we can bill for this? Thank you very much!!

You do not code a 99211 for a vaccine only. It is included in the administation, which by the way you left off. You need to code 90471 for the admin of the vaccine.

 

[suishay]

Thank you very much for all of your helps