Wiki varicella - shingles vaccination

[KristieStokesCPC]

I'm getting denials from Medicare - we billed the shingles vaccination V05.4 with CPT 90471 (also tried the nurses code 99211). Medicare has denied because of the V code. Has anyone had any luck getting this paid?

Thanks

 

[KristieStokesCPC]

After reading more should I be billing V05.4 for Shingles immunization or V05.8?

 

[kbarbag]

Check CMS web site, I think that vaccine is covered under part D. You should get pd for the administration and then the pt should pay you for vaccine and submit to part D

Good luck

 

[dmaec]

the Vcode we use for the Zostavax/shingles vaccine (90736) is V04.89 - we also add a GY modifier to the 90736.GY and we use the 90471 administration.