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We administered a zoster vaccine that the patient purchased at a pharmacy through Medicare Part D. We filed 90471 for administration and it was denied. Can anyone clarify code to file for administration Part B?
Pharmacies may not bill Medicare Part B for drugs furnished to a physician for
administration to a Medicare beneficiary. When these drugs are administered in the
physician's office to a beneficiary, the only way these drugs can be billed to Medicare
is if the physician purchases the drugs from the pharmacy. In this case, the drugs are
being administered “incident to” a physician's service and pharmacies may not bill
Medicare Part B under the “incident to” provision.