medicare with no visit: 90658 or 90662(for new High dose vaccine) and G0008
G0009 is for administration of Pneumonia vaccine
medicare with a OV use the 25 modifier on the E & M code with diagnosis for the visit
and flu shot same as above with the ICD-9, V04.81, code on flu vaccine codes
for commercial product no office visit
use the CPT code that matches the vaccine you are using
90655 - 90662 and immunization administration code 90471
for commercial product with office visit
may need to ck with insurance company
but I usually do the OV with 25 modifier with appropiate diagnosis linked to it
and flu shot (again cpt that matches the vaccine you are using) and the administration code 90471 or use the with counseling administration code if indicated.
I have heard that you can use a SK modifier on the flu vaccine (not the administration code)if the pt is a High risk (ie asthmatic) for commercial products
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