Wiki Modifier & G0008

[mstoop1]

The patient came in office he was given a flu shot and a TD shot because had also cut his finger. we billed the O/V with 25 mod, the flu shot, TD, and G0008. Medicare is denying G0008 for not having a modifier. What modifier would i need for that? any help is appreciated!

 

[Om]

When we check in Encoder Pro, mod-59 is allowed with CPT G0008 when we bill CPT G0008 and 90471 together.

 

[mstoop1]

Thats what i was thinking thank you soo much! that was driving me crazy!

 

[kamkole]

I've also billed it this way when you have two immunizations with no modifiers and get it paid:

G0008
90656 (We used Fluarix)

90472
90715

Often when you bill the G0008 and a 90471 they will deny, as they're considering the G0008 the first administration and the 90471 is also considered the first administration so, they bump up against each other. I've never had problems when I add the 90472 with the G0008 code. Hope this helps!

 

[dedicatedcoder]

Yes, I agree with the modifier 59 to be used.

 

[kamkole]

No, I think you would be okay billing these two combinations together since they have the special administration code for H1N1.