Page 1 of 2 12 LastLast
Results 1 to 10 of 15

Separate administrations of flu vaccines

  1. #1
    Location
    Overland Park, KS
    Posts
    1,166
    Default Separate administrations of flu vaccines
    Exam Training Packages
    I was wondering if someone could confirm the correct way to bill and code for pediatric flu-shots for which patients will be coming in for two separate administrations of the flu vaccine. How do you recommend us billing for this and coding for this? I don't really think that the codes are going to be differant, but my docs are questioning this. Thanks.
    Dawson Ballard, Jr., CPC, CEMC, CPMA, CCS-P, CPC-P, CRHC, AAPC Fellow
    Coder

  2. #2
    Location
    Greeley, Colorado
    Posts
    2,045
    Default
    Excellent question...we have this scenario as well, but as far as I can tell, even if given a split dose you can only bill once for the whole thing. Am I wrong?
    Lisa Bledsoe, CPC, CPMA

  3. #3
    Location
    Overland Park, KS
    Posts
    1,166
    Default
    I am thinking the exact same thing. The feeling with my clinic is that they think that since it is two separate administrations, it is billed twice.
    Dawson Ballard, Jr., CPC, CEMC, CPMA, CCS-P, CPC-P, CRHC, AAPC Fellow
    Coder

  4. #4
    Location
    Greeley, Colorado
    Posts
    2,045
    Default
    I don't think you will get paid twice for the same procedure even though it is done twice becasue you wouldn't normally encounter this situation - you get a flu shot once a year. I'd like to hear some other thoughts.
    Lisa Bledsoe, CPC, CPMA

  5. #5
    Default
    If the patient is under 9 years old and they have never had a flu shot, they should receive 2 shots, one month apart. There will be two encounters, two vaccines given so, you can bill for the administration and the vaccine both times. We do get reimbursed by insurance for both. Usually for smaller children, insurance does not question because they see that the DOS are one month apart and they have no prior history of flu vaccines... you may receive a denial on an older child (5yr+) but that is easily overturned with a phone call. Hope this helps.
    Barbara Haskins CPC

  6. Default
    1st visit would be 90655 (if preservative free vaccine used), and 90465 if under 8 years of age and physcian counseled the family first (ie. WCC).

    When coming back in for just the 2nd injection, charge 90655 + 90471. According to Sanofi Pasteur website, you can also charge 99211 along with this.

    You might look at their website at some different billing scenarios.

  7. #7
    Default
    I had the same question myself and was told by our compliance coders to bill for both immunization and administration (either 90657/90658 and 90471) each time. I wasn't sure I agreed w/that, but per others here, sounds like it's worth a shot if we'll get paid for both!

  8. #8
    Location
    Overland Park, KS
    Posts
    1,166
    Default
    Thanks to everyone for the clarifacation on this.
    Dawson Ballard, Jr., CPC, CEMC, CPMA, CCS-P, CPC-P, CRHC, AAPC Fellow
    Coder

  9. #9
    Default fram, cpc
    Hi,
    I work for an FQHC and wanted to know if we bill and e/m code (99211) and the flu vaccine code and administration code, will we get paid?

  10. #10
    Default
    Quote Originally Posted by fram View Post
    Hi,
    I work for an FQHC and wanted to know if we bill and e/m code (99211) and the flu vaccine code and administration code, will we get paid?
    Only if 99211 is appropriate, you have to look at the services provided. Read the CPT instructions for the administration code and if your services go beyond that and are documented in the chart you have a case for 99211 but you cannot code it routinely. Services provided must warrant it.
    Barbara Haskins CPC

Page 1 of 2 12 LastLast

Similar Threads

  1. Flu Vaccines
    By bethb in forum Medicare Regulations
    Replies: 3
    Last Post: 10-13-2015, 01:09 PM
  2. Multiple vaccines administrations same day
    By DMAndre in forum Medical Coding General Discussion
    Replies: 5
    Last Post: 06-12-2010, 06:42 AM
  3. Multiple vaccines administrations same day
    By DMAndre in forum Medical Coding General Discussion
    Replies: 0
    Last Post: 06-09-2010, 05:50 PM
  4. Replies: 7
    Last Post: 01-20-2010, 12:58 PM
  5. Flu vaccines
    By jnieto625 in forum Family Practice
    Replies: 4
    Last Post: 10-15-2008, 01:01 PM

Posting Permissions

  • You may not post new threads
  • You may not post replies
  • You may not post attachments
  • You may not edit your posts
  •  
Enjoying Our Forums?

AAPC forums are a benefit of membership. Joining AAPC grants you unlimited access, allowing you to post questions and participate with our community of over 150,000 professionals.

Join Now Continue Reading Without Full Access

Already a Member?

Login

Close Message

In addition to full participation on AAPC forums, as a member you will be able to:

  • Access to the largest healthcare job database in the world.
  • Join over 150,000 members of the healthcare network in the world.
  • Be a part of an industry leading organization that drives the business side of healthcare.
  • Save anywhere from 10%-50% with exclusive member discounts on courses, books, study materials, and conferences.
  • Access to discounts at hundreds of restaurants, travel destinations, retail stores, and service providers. AAPC members also have opportunities to save on heath, life, and liability insurance.
  • Become a member of a local chapter and attend regular meetings.