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Zostavax Administration

  1. Default Thank you all for posting
    Medical Coding Books
    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
    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
    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. 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
    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. Default
    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
    Independent Contractor
    Medical Coding and Consulting
    Cramer Consulting

  7. 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
    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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