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Thread: Medicaid H1N1 Coding

  1. #11
    Join Date
    Apr 2007
    Alexandria, VA


    AAPC: Back to School
    Quote Originally Posted by jod867 View Post
    For medicaid we are doing 90663 with $.01 for the charge and 90470 for the admin. You aren't allowed to charge for the vaccine itself because its government funded. but you should get paid for the Admin. My system rejects the 90470 as a invalid code but medicaid does pay for it. also the DX code is the V04.81 as stated above. I hope that helps.
    THIS INFORMATION IS SOLEY CORRECT.....This is how we are billing and we are getting paid...
    Yolanda T. Haskins CPC, CRC, OHCC
    AAPCCA Board of Directors 2014 - 2017
    Region 1 - NorthEast - ME, NH, VT, MA, RI, CT, NY


    Alexandria, VA Chapter

    ~ Practice Kindness ~

  2. #12
    Join Date
    Apr 2007
    Columbia, MO


    Everyone does realize I hope that the 90470 is a CPT code that was deleted in 1999, and the problem with the payers rejecting it as invalid is that the electronic system did not get the message that the code was revitalized on Sept 28th to be for the admin of H1N1. You will need to communicate this with some payers so they can fix the edits. This is why some get an edit for invalid code.

    Debra A. Mitchell, MSPH, CPC-H

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