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Modifier needed on G0008 and G0009

moremopars1

Contributor
Messages
14
Location
CoeurD'Alene, Idaho
Best answers
0
If a patient has Medicare and is given both the Pneumovac and the Flu Vac. You use G0008 for the flu vac and G0009 on the Pneumo administration. Does the G0008 or G0008 :confused:require a modifier?
 

renabranch1

Contributor
Local Chapter Officer
Messages
11
Location
Houston, Texas
Best answers
0
G008

I coded the G008 and was told to us an administration modifier this is the way i coded it:
example: 99213 v040.81 am
99060 G008
that's what i was advised to do by my dr we called texas health springs, so far none have been returned hope it helps.::eek::cool:;)
 

aclements

Networker
Messages
89
Location
Covington, LA
Best answers
0
No modifier is needed. G0008 states administration of influenza vaccination and G0009 states administration of pneumococcal vaccination
 

cdr4life

Networker
Messages
71
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0
Confused!!!

So if I don't need to put a modifier on G0009 or G0008, how come when I call Medicare to fix the claim, they say I need a modifier? I'm so confused and bummed because our doctors aren't getting paid for a G0008 or G0009.
 

LOVE2CODE

Expert
Messages
392
Location
Alexandria, VA
Best answers
0
So if I don't need to put a modifier on G0009 or G0008, how come when I call Medicare to fix the claim, they say I need a modifier? I'm so confused and bummed because our doctors aren't getting paid for a G0008 or G0009.
You have to use a modifier on the e/m code (25) not on the G codes. Hope this clarifies your question.:)
 

cdr4life

Networker
Messages
71
Best answers
0
another question

okay so let me give you an example so i can fully understand where you're coming from.

Example:

Medicare patient comes in for a regular office visit (99213), and is administered a Pneumovax shot (G0009). I would have to put the modifier 25 on the office visit (99213). is that what i need to do??
 

cdr4life

Networker
Messages
71
Best answers
0
references

do you have any resources you can give me for this modifier for the G0009 or G0008? I beleive my email is on my account. Thanks :)
 

LOVE2CODE

Expert
Messages
392
Location
Alexandria, VA
Best answers
0
okay so let me give you an example so i can fully understand where you're coming from.

Example:

Medicare patient comes in for a regular office visit (99213), and is administered a Pneumovax shot (G0009). I would have to put the modifier 25 on the office visit (99213). is that what i need to do??
Yes, that is what you need to do. The modifier 25 is alway attached to the E/M code. :)
 

brendalewing

Networker
Local Chapter Officer
Messages
29
Best answers
0
Any time you give an injection, with an office visit, you must use modifer 25 on the office visit to get paid for both... not just G codes..... examples

99213-25
Q2036
G0008

or

99213-25
J1030
96372

Hope this helps.
 
Messages
1
Best answers
0
I too was told the same thing by Medicare - G0008 must have a modifier when billed with multiple vaccines.
G0008 = 90662
G0009 = 90732

The problem I have, other patient with the exact same bill are paid no problem by Medicare. Its as if they are choosing randomly which codes need a modifier.
 
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