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Thread: Flu Shots

  1. #1
    Join Date
    Apr 2007

    Default Flu Shots

    When coding for an office visit for bp/med check and a flu shot is administered should you code for the office visit plus modifier and G0008. My physiician is coding office visit and 90471. The office visit is not being paid and 90471 is.

  2. #2


    if the physician did see the patient and the pt'S BP was a sable chronic condition then you code a low level OV 99211-25 with the flu shot for medicare pts would be G2038 and G0008 or a non medicare pt 90658 AND 90471, however if the ma did the bp check and flu shot then no OV just the the flu shot.

  3. #3
    Join Date
    Apr 2007
    Dover Seacoast New Hampshire


    The 99211 (nurse visit) is bundled into the flu shot, regardless of what else was done. If your physician also saw the patient, bill the appropriate E&M code based on the separately-identifiable key components (stable chronic problem is generally a 99212, but the HPI or exam also have to meet that level), then bill the CPT code for the appropriate flu vaccine, and either 90471 or G0008 (Medicare). Even if the nurse did a BP check, don't also bill the 99211. Make sure the diag for the OV is different from the flu diag-- V04.81. Some payers like the -25, but I wouldn't add it as a matter of course, check with them first.
    Pam Brooks, MHA, CPC, PCS, COC
    Coding Manager
    Wentworth-Douglass Hospital
    Dover, NH 03820
    AAPCCA Board of Directors (Region 1--ME, NH, VT, MA, RI, CT, NY)

    If you can dream it, you can do it. Walt Disney

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