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Thread: Zostavax Administration

  1. #11

    Default Thank you all for posting

    AAPC: Back to School
    G0377 is not in the 2010 HCPCs so I will go with the G0008 code only. We order and the patientpicks it up so the only code to charge is the administration fee.

  2. #12
    Join Date
    Apr 2007


    For administring the PART D vaccine ie ZOSTAVAX,should the provider have contract with part d.We are IM and have part B.

    May I request some light on this subject.


  3. #13
    Join Date
    Apr 2007
    Greeley, Colorado


    Quote Originally Posted by DeeCPCPNH View Post
    G0377 is not in the 2010 HCPCs so I will go with the G0008 code only. We order and the patientpicks it up so the only code to charge is the administration fee.
    G0377 has been deleted, but using G0008 would not be appropriate as that is for influenza vaccine administration.

    So if we bill 90471 with 90736 how does Medicare know not to pay? Should an ABN be obtained and GZ and/or GY applied or is the ABN necessary?
    Lisa Bledsoe, CPC, CPMA

  4. #14

    Smile Toni, CPC

    We are just starting to offer the Zostavax here in our clinic. Our first patient is Medicare/Tricare. Anyone out there been paid on this similar situation? I would love to know the reimbursement amount. Thanks for any input.

  5. #15
    Join Date
    Apr 2007
    Gainesville, GA


    We use E-Dispense. Our drug rep. came along and got us set up with this company. We put in the patient information and the system tells us what the patient is responsible for and the patient must pay his/her portion at time of service. Then we file the claim with E-Dispense on their web site and they send the payments straight to us. This has worked well for us so far.

  6. #16
    Join Date
    Apr 2007
    Fayetteville, North Carolina


    We are not giving the Zostavax to Medicare patient's in the office. Medicare only covers the Zostavax as a Part D benefit, therefore, if given by a Medicare Part B (doctor's office) provider, the Zostavax will be denied as patient responsibility. We are giving our Medicare patient's a script to be filled and administered at the local pharmacy. You currently don't have to have an ABN signed for the service to be billable to the patient, it is currently never covered by Medicare Part B and does not require an ABN.

    Stefanie Cramer, CPC
    Sr. Coding Specialist
    Cape Fear Valley Health Systems

  7. #17

    Default Zostavax administration fee

    So, now that the G0377 is not in the HCPCS book, can we safely guess that we are suppose to use 90471?

  8. #18
    Join Date
    Apr 2007
    Melbourne, Florida

    Default Zostivax

    So does that mean for Medicare Patients we bill 90736 + 90471 GY with dx V05.8
    or just 90736 w/ dx V05.8? Thanks for the feedback :0
    Denise Gilrane-Pillow, CPB

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