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Thread: Injection code for Medicaid

  1. #1

    Default Injection code for Medicaid

    Good Morning,

    I am hoping for some help with billing the injection code (given with flu shot) to Medicaid. I have tried the G0008 as well as a 90471. Both have been rejected. I have called Medicaid and was told we are billing wrong but they can not tell how to bill. Any help is greatly appreciated.

    Gmitch02

  2. #2
    Join Date
    Apr 2007
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    Lubbock, TX
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    Default

    Quote Originally Posted by gmitch02 View Post
    Good Morning,

    I am hoping for some help with billing the injection code (given with flu shot) to Medicaid. I have tried the G0008 as well as a 90471. Both have been rejected. I have called Medicaid and was told we are billing wrong but they can not tell how to bill. Any help is greatly appreciated.

    Gmitch02
    If the patient's under 18 and it was given by a doctor, PA, or FNP, then you'd use 90460.

  3. #3

    Default

    Thank you Brandi but what if they are over the age of 18 and are under Medicaid because of pregnancy?

  4. #4
    Join Date
    Apr 2007
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    Lubbock, TX
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    According to the AAP (http://practice.aap.org/content.aspx?aid=1808), 90471 - 90474 should be used. G0008 is only for Medicare as far as I know, but your 90471 shouldn't have denied, unless you tried to bill more than one 90471 on the claim, or if you also billed 90473. If either of those two situations is the case, then change the admin code to 90472, and you'll be good to go. If the flu vaccine was the only vaccine administered at the time, and you only reported 90471 once (with no 90473, either), then the denial is either a local coverage determination (Medicaid is weird like that - they just make up their own rules sometimes), or it was an incorrect denial, and just needs to be reprocessed. What did your denial say, when you billed 90471?

  5. #5

    Default Thank you!!

    Brandi,

    Thank you for all your informative posts!! You have been a great help!!

    Tim Maher, CPC

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