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Thread: Zostavax injection 90736

  1. #1

    Default Zostavax injection 90736

    AAPC: Back to School
    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?

  2. #2
    Join Date
    Apr 2007
    Seacoast- Dover New Hampshire

    Default 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.
    Karen Barron, CPC
    Hampton New Hampshire Chapter

  3. #3


    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?

  4. #4
    Join Date
    Apr 2007
    North Carolina

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