The ICD-10 code to use for flu vaccination is Z23, encounter for immunization. There are many CPT codes to describe influenza vaccine, varying by manufacturer, product and age group.
Administration services for these preventive vaccines are reported to Medicare using HCPCS codes as follows: G0008 administration of influenza virus vaccine.
For vaccines given the same day as a G-Code vaccine, use 90471. For example, if a patient receives a flu shot and tetanus shot, you would bill G0008 for the flu vaccine and 90471 for the tetanus vaccine; also add modifier 59 (distinct procedural service) to the G code.
90471 One vaccine, single or combination vaccine/toxoid. Immunization administration (includes percutaneous, intradermal, subcutaneous or intramuscular injections).
How Do I Bill for Administering COVID-19 Vaccines?You must be a Medicare-enrolled provider to bill Medicare for administering COVID-19 vaccines to Medicare patients. ... You can bill on single claims for administering the COVID-19 vaccine, or submit claims on a roster bill for multiple patients at a time.More items...•
Code Z23, which is used to identify encounters for inoculations and vaccinations, indicates that a patient is being seen to receive a prophylactic inoculation against a disease. If the immunization is given during a routine preventive health care examination, Code Z23 would be a secondary code.
Use separate administration codes for the seasonal influenza virus (G0008) and pneumococcal (G0009) vaccines. Medicare pays both administration fees if a beneficiary gets both the seasonal influenza virus and the pneumococcal vaccines on the same day.
Influenza HCPCSHCPCS / CPTDescriptionG0008Administration of influenza virus vaccine (allowable same as90653Influenza virus vaccine, inactivated, subunit, adjuvanted, for intramuscular use10 more rows•Oct 13, 2021
Coverage for shingles vaccine Original Medicare doesn't pay for this immunization under Part A or Part B. That means, medical practice can't give it to Medicare patients and be reimbursed for it. “Generally, Medicare prescription drug plans (Part D) cover all commercially-available vaccines.”
To report three intramuscular injections, report 90471 for the initial intramuscular vaccination administration and 90472 x 2 for the additional intramuscular administrations.
The 90460 code is used when a physician is present and performs face-to-face counseling to the caregiver or parent. This code can only be used for patients through age 18. Code 90471 is used when the drug is administrated by a medical assistant or nurse and the patient does not see the physician at all.
Vaccine CPT Code to ReportCPT Code Description90688Influenza virus vaccine, quadrivalent (IIV4), split virus, 0.5 mL dosage, for intramuscular use90756Influenza virus vaccine, quadrivalent (ccIIV4), derived from cell cultures, subunit, antibiotic free, 0.5 mL dosage, for intramuscular use4 more rows•Aug 31, 2021
Vaccine CPT Code to ReportCPT Code Description90688Influenza virus vaccine, quadrivalent (IIV4), split virus, 0.5 mL dosage, for intramuscular use90756Influenza virus vaccine, quadrivalent (ccIIV4), derived from cell cultures, subunit, antibiotic free, 0.5 mL dosage, for intramuscular use4 more rows•Aug 31, 2021
You can charge your patient for the cost of the influenza vaccine. You can't bill Medicare for the vaccine itself.
The 90460 code is used when a physician is present and performs face-to-face counseling to the caregiver or parent. This code can only be used for patients through age 18. Code 90471 is used when the drug is administrated by a medical assistant or nurse and the patient does not see the physician at all.
Use CPT code 90471 to code for administration because the patient is an adult and this is the first vaccine administered at the visit.