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Modifier & G0008

  1. #1
    Default Modifier & G0008
    Exam Training Packages
    The patient came in office he was given a flu shot and a TD shot because had also cut his finger. we billed the O/V with 25 mod, the flu shot, TD, and G0008. Medicare is denying G0008 for not having a modifier. What modifier would i need for that? any help is appreciated!

  2. #2
    When we check in Encoder Pro, mod-59 is allowed with CPT G0008 when we bill CPT G0008 and 90471 together.
    Om CPC

  3. #3
    Thats what i was thinking thank you soo much! that was driving me crazy!

  4. #4
    I've also billed it this way when you have two immunizations with no modifiers and get it paid:

    90656 (We used Fluarix)


    Often when you bill the G0008 and a 90471 they will deny, as they're considering the G0008 the first administration and the 90471 is also considered the first administration so, they bump up against each other. I've never had problems when I add the 90472 with the G0008 code. Hope this helps!

  5. Default
    Yes, I agree with the modifier 59 to be used.

  6. #6
    Bristol VA
    What about the administration of the Influenza A & B Vaccine?
    I've got the G9141 & G9142 for the H1N1 and 90658 & G0008 for the seasonal. Would I need to use 90472 instead of the G9142?
    Amy Chapman Suiter, CPC, CPMA
    President - Bristol VA Local Chapter - 2010
    President - Kingsport TN Local Chapter - 2009
    President Elect - Kingsport TN Local Chapter - 2008

  7. #7
    No, I think you would be okay billing these two combinations together since they have the special administration code for H1N1.

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