Results 1 to 8 of 8

FLU Shot HCPCS Code

  1. #1
    Default FLU Shot HCPCS Code
    Medical Coding Books
    I am new to the flu shot coding. Please help me!

    I was able to find codes:
    -V04.81 for my health patient getting the flu shot
    -90658 for my non-Medicare patient getting the flu shot

    Shouldn't there be a HCPCS code for the actual vaccine??? Am I blind?

    Please help me

    Thanks
    Kim

  2. #2
    Location
    Salisbury, MD
    Posts
    27
    Default
    90658 is a vaccine code. 90476-90749 are Vaccines/Toxoids

    90465-90474 are the Immunization Administration Codes for Vaccines/Toxoids. Remember to look at your headings before the codes.

  3. #3
    Default
    Per the CMS website, G9142 is the code for the vaccine itself but if provided at no charge by the government, will not be reimbursed, of course. Hope this helps!

  4. #4
    Location
    Salisbury, MD
    Posts
    27
    Default
    G9142 is specifically for H1N1 flu vaccine only.

  5. #5
    Default
    If it is seasonall flu and administrated via (IM/SQ) you may have to add the administration code 90471.

  6. Default
    First you need to know the age of the patient there are different codes
    depending on the age... the 90658 is for individuals 3 years and older..
    The administration code will be depending on their age.
    For Medicare the administration code is G0008..
    Hope this helps

  7. #7
    Smile
    Quote Originally Posted by kimt View Post
    I am new to the flu shot coding. Please help me!

    I was able to find codes:
    -V04.81 for my health patient getting the flu shot
    -90658 for my non-Medicare patient getting the flu shot

    Shouldn't there be a HCPCS code for the actual vaccine??? Am I blind?

    Please help me

    Thanks
    Kim
    For non-medicare pt --the admin code is 90471 if over 8 years old and 90465 if under 8 years old...
    The HCPCS code are used for medicare pts and that code is G0008...

    No you are not blind....lol
    Yolanda T. Haskins CPC, CRC, OHCC, AAPC Fellow
    Past AAPCCA Board of Directors 2014 - 2017


    Alexandria, VA Chapter

    ~ Practice Kindness ~

  8. #8
    Default
    You will want to bill a 90471 for the administration, and a 90658 for the actual vaccine. Dx of v04.81 for both. This is for an adult.

    Medicare: G0008 for the administration, and the 90658 for the vaccine.

    For children, it's a little bit different. You will want to use the 90465 for the admin if the pt is under 8. For the vaccine, you will use the 90657 if the pt is 6-35 mos of age.

Similar Threads

  1. E/M and Flu Shot
    By donnakrysl@adapt.us in forum Modifiers
    Replies: 2
    Last Post: 12-03-2013, 09:19 AM
  2. Flu shot
    By bforr in forum E/M
    Replies: 2
    Last Post: 08-06-2013, 08:52 AM
  3. Flu shot admin code G0008 getting denied
    By MarilynS in forum Billing/Reimbursement
    Replies: 0
    Last Post: 01-13-2012, 08:26 AM

Posting Permissions

  • You may not post new threads
  • You may not post replies
  • You may not post attachments
  • You may not edit your posts
  •  
Enjoying Our Forums?

AAPC forums are a benefit of membership. Joining AAPC grants you unlimited access, allowing you to post questions and participate with our community of over 150,000 professionals.

Join Now Continue Reading Without Full Access

Already a Member?

Login

Close Message

In addition to full participation on AAPC forums, as a member you will be able to:

  • Access to the largest healthcare job database in the world.
  • Join over 150,000 members of the healthcare network in the world.
  • Be a part of an industry leading organization that drives the business side of healthcare.
  • Save anywhere from 10%-50% with exclusive member discounts on courses, books, study materials, and conferences.
  • Access to discounts at hundreds of restaurants, travel destinations, retail stores, and service providers. AAPC members also have opportunities to save on heath, life, and liability insurance.
  • Become a member of a local chapter and attend regular meetings.