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Wiki Zostavax injection 90736

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Kathy615

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What is the correct administration code to bill Medicare for the Zostavax vaccine? I realize that both the vaccine and it's administration is not covered under Med B but we sometimes have to bill for a rejection in order to bill the patient's secondary insurance (Empire). Also, I assume I need to bill both the vaccine & admin of with modifier GY showing that I am aware that it is not a covered service. Right?
 
Zostervax

We have the pt pay up front. Medicare will not pay for the vaccine or the administration of the same. I would use the GY modifier as I would not use the GZ not medically necessary.
 
We do not have the patient pay up front because the service is paid by the secondary insurance that we participate with. So, knowing that Medicare is going to deny what injection code should I use?
 
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