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flu vaccine

Cathy Posted Mon 09th of November, 2015 17:34:45 PM

I am giving flu vaccines in an obgyn office. Do I have this correct
90471 (medicaide and insurance patients for admistration and G0008 (medicare). Is Z23 the correct Icd10 code. Are there any modifiers needed. I have been told that traditional medicaid is not paying. Is this true. If the patient is pregnant do I need to add an addtional code for pregnancy--weeks? Is there anything else I am missing.
Thank you

SuperCoder Answered Tue 10th of November, 2015 04:32:19 AM

Hi Cathy,

I am not a right contact person for medicaid policy. Contact with medicaid is better to know about their policy regarding flu vaccine reimbursement.
CPT code 90471/G0008 with ICD Z23 is correct and there is no modifier required for this service.

Vaccinations services performed during the pregnancy should billed separately at the time of the service. if the patient has any condition that make them high-risk for influenza, report a secondary code for high-risk condition. This will facilitate payment from plans that only cover vaccination for patient identified as high-risk.

Cathy Posted Mon 16th of November, 2015 19:45:12 PM

Can you give the flu vaccine at the time of antepartum visit. For 90471 the reimbursement is only 7.34 and the med was reimburse at 13.28. I put a modifier 25 on the EM.? Seems awfully low for injections fee

Thank you

SuperCoder Answered Tue 17th of November, 2015 07:53:57 AM

Hi Cathy,

Yes, we can give a flu vaccine at the time of antepartum visit.

Your coding and billing is correct. Please contact with your provider about reimbursement policy for CPT 90471 during pregnancy.

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