Wiki VFC Administration in Illinois

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tammymills97

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Bourbonnais, IL
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I just got off the phone with Illinois HFS about rejections for VFC vaccine administrations. The person that I spoke with told me that they do not pay for 90471 et al for the administration codes but they will reimburse us for the administration. He then told me that I should consult the practioner fee schedule for which codes they will cover. When I did look at this, none of the vaccine administration (90465 etc.) codes are on there. Can someone please give me some guideance as to how your practice is coding these for reimbursement?
 
I am in CA but here we bill the vaccine code itself and they pay the "admin" by vaccine only .We do not bill the admin codes but the vaccine code.
Example
We bill only 90663 Hep A they pay $9.00 ,this covers the administration code.Since the vaccine is free.
 
I am in MO and we do not bill the admin codes, only the codes for the vaccine, with the exception of the H1N1 codes. We bill for both the admin and the med for that one.
 
We were diected by IDPA to charge the vaccine CPT code with the administration fee (since the vaccine is free) and the NDC number. Since we began billing VFC this way, we have had no issues with reimbursement.
 
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