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Medicare OV, TD Vac and Influenza CODING HELP!!!!

  1. Wink Medicare OV, TD Vac and Influenza CODING HELP!!!!
    Medical Coding Books
    I am coding a new pt visit

    99203,25
    90718,gy
    90471 and
    90658 with G0008.

    My CCI edits keep me from getting claim billed stating that G0008 is component of 90471.. How do I code this to get it billed? That is how I currently have it in my sysytem..

    Thanks
    Danielle
    480-505-3484

  2. #2
    Location
    Sioux Falls South Dakota
    Posts
    358
    Default
    That is because both 90471 and G0008 are "initial" vaccine administration codes. You should use 90472 for the admin for the tetanus and then you'll be good to go.
    Lucinda (Cindy) McGarry, CPC-P
    Applications Specialist
    Avera Health Plans
    Education Office Sioux Falls SD Local Chapter
    Past President Sioux Falls SD Local Chapter

  3. #3
    Default
    Quote Originally Posted by cmcgarry View Post
    That is because both 90471 and G0008 are "initial" vaccine administration codes. You should use 90472 for the admin for the tetanus and then you'll be good to go.
    Cindy couldn't we use modifier 59 on the G0008 as well?
    Brenda Amaro, CPC

  4. #4
    Location
    Sioux Falls South Dakota
    Posts
    358
    Default
    Quote Originally Posted by BRENDA28 View Post
    Cindy couldn't we use modifier 59 on the G0008 as well?
    You shouldn't need a 59 modifier on the G0008. The 25 on the E/M shows that it is distinct/separate from the vaccine administrations. You use one initial admin code (in this case G0008) when billing for multiple vaccinations, and then the additional admin code for each subsequent vaccination. If you had more, that you then had to also bill the 90472 for, you would use a 59 on those (but not the first one).

    Thanks,
    Lucinda (Cindy) McGarry, CPC-P
    Applications Specialist
    Avera Health Plans
    Education Office Sioux Falls SD Local Chapter
    Past President Sioux Falls SD Local Chapter

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