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Influenza Coding

  1. #1
    Default Influenza Coding
    Medical Coding Books
    Our cardiology office has never given Influenza shots before to patients before. We will be giving them this year and I need some help. We have mostly medicare patients. We will be using Flulaval .05ml. I believe that code is 90658. Do I use that code or teh G code
    G0008? Do I use any other codes? We will be asking the patients when they come in for their regular appointments if they would like the vaccine. So then would the office visit get a 25 modifer also? I would appreciate any help I could get.
    Thank you,

  2. Default
    For Medicare patients, you would bill the G0008 administration code in addition to the 90658. There's no requirement for a modifier 25 on the office visit when flu shots are billed.


  3. #3
    Thanks Melissa, So for Medicare pts I should post 90658 and G0008? What about medicare replacement polices and the few the few commerical patients? I am sorry, but I can use all the help I can get.
    Thanks again

  4. #4
    You would post the Medicare Advantage plans the same as you do Original Medicare. As for other commerical payers, use 90471 for the administration code and the appropriate flu vaccine code.

    I hope this helps!
    Teresa Collins, CPC

  5. #5
    Cannot bill 90658 for Medicare anymore. You must bill Medicare by the specific brand for instance Flulaval is Q2036 and the administration G0008

  6. #6
    For Fluvirin brand use CPT Q2037

  7. Default help
    I know we use Q2037 and G0008 for Medicare, for our office. But what is it for all other commercial insurances..did I miss an article?

  8. #8
    Ft. Worth, Texas
    You would use codes from 90655-90668 series along with 90471 administration code for commercial insurance companies.


  9. Default
    I have been doing alot of reseach on this and there are many new codes for this i received a couple of denials already 90658 is no longer a good code for anyone i googled AETNA, BCBS, and CIGNA who say vaccine is free and you only bill for administration using either(new codes) 90470 or G9141. Medicare and Geisinger G0008 and the new Q2035-Q2039. This as as far as i have got but will cotinue to keep updated if i find out more. UHC G9141.
    Last edited by ANDREAHSANCHEZ; 10-13-2011 at 12:28 PM.

  10. #10
    Everett, WA
    Per Palmetto MCR CPT 90658 is no longer valid and replacement "Q" codes are now in effect. ---Suzanne

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