Wiki SHINGRIX ADMINISTRATION BILLING

LMOuellette

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Hello, I work for a multispeciality practice. We have been receiving denials for the administration of the vaccine. We provide a patient with a script for the vaccine they go to pharmacy and pick up and then bring to office for administration. We are billing with Z23 with cpt code 90471. Can someone tell me why we cannot get this paid. It has something to do with DX however I don't see a clear dx for prevention of Shingles. Help.
 
We bill Z23 for the dx and 90750 - FB with zero charge. The FB modifier indicates that the patient provided the vaccine. We have no problem getting paid.
 
Hello, I work for a multispeciality practice. We have been receiving denials for the administration of the vaccine. We provide a patient with a script for the vaccine they go to pharmacy and pick up and then bring to office for administration. We are billing with Z23 with cpt code 90471. Can someone tell me why we cannot get this paid. It has something to do with DX however I don't see a clear dx for prevention of Shingles. Help.
hello
we are getting denials too .
 
If you are billing a zero charge how are you getting paid just curious?
The zero charge is on the vaccine. I did not make myself clear. We bill Z23 for the dx and 90471 and 90750-FB. There is a fee attached to the admin charge but not the vaccine itself.
 
If you are billing a zero charge how are you getting paid just curious?
And is FB a new modifier? I don't see it in the CPT book.
The zero charge is on the vaccine. There is a fee for the admin charge. That is what we get paid for.
OMG, thank you, thank you. I have trying to research this for a couple of weeks with no mention of this. You are an angel. Thank you
 
Hi - FB is not a new modifier. It might be in the HCPCS book. BTW - you may not be paid for this if you are adding it an office visit. If you find that some of them pay and some don't you will have to start looking at payer policies.
 
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