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Medicaid H1N1 Coding

  1. Default Medicaid H1N1 Coding
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    Hi,

    Had anyone coding H1N1 for Medicaid yet? What CPT and ICD 9 code that you used? Is Medicaid pay? My claims got rejected as reason: invalid!!! Due to I used CPT code G9141 for injection administration. Can anyone tell me?Thank you.

    Dawn

  2. #2
    Location
    Twin Falls, ID
    Posts
    41
    Default H1N1 medicaid adm
    I believe that you should only be using 90470 to bill adm of H1N1 to Medicaid. The 'g' code you submitted should only be used for MEDICARE claims. Anyone can correct me if I'm wrong.

  3. Thumbs up
    I agree. You should only use 90470 for Medicaid as G codes are used for Medicare.
    Neha Bhatnagar CPC, CPC-H

    "Believe you can and you're half way there."

  4. #4
    Location
    Columbia, MO
    Posts
    12,570
    Default
    The G codes are definitly for Medicare, however they are designated as carrier discretion use so other carrier could use the G if they wish, sounds like your Medicaid does not wish.

    Debra A. Mitchell, MSPH, CPC-H

  5. #5
    Location
    Tacoma
    Posts
    22
    Default H1N1 with Medicaid & other carriers
    We are using G9142 with DX V04.81, and no administration charge for medicaid patients, for all other insurances we are using 90470 with 90663 and the DX of V04.81

    Good Luck to everyone on getting paid

  6. #6
    Location
    Minneapolis MN
    Posts
    84
    Default
    Our Medicare and Medicare replacement products require the G codes, but the rest of our payers including Medicaid will accept either G codes or CPT codes.

  7. #7
    Location
    South Salt Lake City
    Posts
    48
    Default
    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.
    Jody Thompson, CPC

  8. #8
    Default
    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.

    That is all correct except the dx is 488.1

  9. #9
    Location
    Columbia, MO
    Posts
    12,570
    Default
    Quote Originally Posted by Kirstyn20 View Post
    That is all correct except the dx is 488.1
    488.1 is the dx code for patients with confirmed H1N1 virus dx. NOT for the vaccine admin. That is the V04.81. DO NOT give the patient the dx of having the H1N1 virus when they do not!

    Debra A. Mitchell, MSPH, CPC-H

  10. #10
    Location
    St. Cloud, MN
    Posts
    58
    Default
    the V04.81 is definately correct, not the 488.1 as you stated

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