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Vaccines for children

  1. Default Vaccines for children
    Medical Coding Books
    Just wondering if these vaccines are billable? I am receiving two different answers - bill the vaccine, but not the administration. Or bill the administration, but not the vaccine. Please let me know your policy!!!

  2. #2
    To my understanding you can bill VFC to your state medicaid without an administration code. Any other insurance you cannot bill, the patient would be responsible for the VFC price of the immunization but not the administration.

    Since VFC is state provided the price you charge for the VFC vaccine itself is in replace of the administration charge and therefore the administration charge is dropped.

    Hope this helps!
    Cheryl Miles, CPC

  3. Default
    Ok, thanks so much for the answer. This is what they are billing, however, I noticed in the medicaid manual it states to bill the administration codes only. But, our state medicaid manual always seems to have problems so I will just call medicaid!!

  4. Default Vfc
    For tracking purposes within our own practice management software, we bill both the vaccine and the administration codes, then adjust off the vaccine and then adjust the admin. codes down to the allowable. This way, if we need to run a report on all children who have received a certain vaccine, I can pull that information from our system. If we don't have it in there, then we can't pull it for a report. It also helps me to balance the amount of VFC vaccine we are giving against the actual numbers we have written off. Making sure the nurses aren't giving expensive commercial vaccine to VFC eligible and the opposite.

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