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varicella - shingles vaccination

  1. #1
    Default varicella - shingles vaccination
    Exam Training Packages
    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
    Sincerely,

    Kristie Stokes, CPC, CPMA, CCS, CMDP, ICDCT-CM

    AAPCCA Board of Directors 2014-2017
    Region 1 - Northeast
    Maine, New Hampshire, Vermont, Massachusetts, Connecticut, Rhode Island, New York

    Today, give a stranger one of your smiles. It might be the only sunshine they see all day.

  2. #2
    Default
    After reading more should I be billing V05.4 for Shingles immunization or V05.8?
    Sincerely,

    Kristie Stokes, CPC, CPMA, CCS, CMDP, ICDCT-CM

    AAPCCA Board of Directors 2014-2017
    Region 1 - Northeast
    Maine, New Hampshire, Vermont, Massachusetts, Connecticut, Rhode Island, New York

    Today, give a stranger one of your smiles. It might be the only sunshine they see all day.

  3. #3
    Default
    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

  4. #4
    Location
    Duluth, Minnesota
    Posts
    1,133
    Default
    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.
    Donna, CPC, CPC-H

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