Guest guest Posted November 3, 2008 Report Share Posted November 3, 2008 Quick question cause I am starting to get some medicare rejections. Coding for regular visit..99211-99213 depending on the situation. code for vax: 90658 and adm G0008. What about the modifiers? Do I put a -25 on the visit alone? Do I leave out the -25 modifier? I am so confused! Help! Quote Link to comment Share on other sites More sharing options...
Guest guest Posted November 3, 2008 Report Share Posted November 3, 2008 Sofia, For Medicare, it is G0008 as you are using, with a diagnosis code of V0481 and CPT code 90658 (as you are using). The modifier -25 is to be used with the 99211-5 to distinguish that it is a separately identifiable service. Hope that helps. Soma Mandal Subject: flu vax coding questionTo: Date: Monday, November 3, 2008, 5:53 PM Quick question cause I am starting to get some medicare rejections.Coding for regular visit..99211- 99213 depending on the situation.code for vax: 90658 and adm G0008. What about the modifiers? Do I put a -25 on the visit alone? Do I leave out the -25 modifier? I am so confused! Help! Quote Link to comment Share on other sites More sharing options...
Guest guest Posted November 3, 2008 Report Share Posted November 3, 2008 Just to add to that, Medicare will not pay for a 99211 for just a vaccine administration. So don’t bother billing it unless you want to spend the time to adjust off all those charges. If you did something else, like urine dip or read a PPD or something, then you can bill the 99211 but you will need a separate ICD-9 code too. Kathy Saradarian, MD Branchville, NJ www.qualityfamilypractice.com Solo 4/03, Practicing since 9/90 Practice Partner 5/03 Low staffing From: [mailto: ] On Behalf Of Soma Mandal Sent: Monday, November 03, 2008 1:21 PM To: Subject: Re: flu vax coding question Sofia, For Medicare, it is G0008 as you are using, with a diagnosis code of V0481 and CPT code 90658 (as you are using). The modifier -25 is to be used with the 99211-5 to distinguish that it is a separately identifiable service. Hope that helps. Soma Mandal From: Sofia Fernandez, MD Subject: flu vax coding question To: Date: Monday, November 3, 2008, 5:53 PM Quick question cause I am starting to get some medicare rejections. Coding for regular visit..99211- 99213 depending on the situation. code for vax: 90658 and adm G0008. What about the modifiers? Do I put a -25 on the visit alone? Do I leave out the -25 modifier? I am so confused! Help! Quote Link to comment Share on other sites More sharing options...
Guest guest Posted November 3, 2008 Report Share Posted November 3, 2008 sofiaI am really glad you are confusedI have been open 3 1/2 yrs and i am always confused . I wish vaccines would just go away.I think that if you are not confused in primary care it means you ar e not paying attention:) Just to add to that, Medicare will not pay for a 99211 for just a vaccine administration. So don't bother billing it unless you want to spend the time to adjust off all those charges. If you did something else, like urine dip or read a PPD or something, then you can bill the 99211 but you will need a separate ICD-9 code too. Kathy Saradarian, MD Branchville, NJ www.qualityfamilypractice.com Solo 4/03, Practicing since 9/90 Practice Partner 5/03 Low staffing From: [mailto: ] On Behalf Of Soma Mandal Sent: Monday, November 03, 2008 1:21 PM To: Subject: Re: flu vax coding question Sofia, For Medicare, it is G0008 as you are using, with a diagnosis code of V0481 and CPT code 90658 (as you are using). The modifier -25 is to be used with the 99211-5 to distinguish that it is a separately identifiable service. Hope that helps. Soma Mandal From: Sofia Fernandez, MD Subject: flu vax coding question To: Date: Monday, November 3, 2008, 5:53 PM Quick question cause I am starting to get some medicare rejections. Coding for regular visit..99211- 99213 depending on the situation. code for vax: 90658 and adm G0008. What about the modifiers? Do I put a -25 on the visit alone? Do I leave out the -25 modifier? I am so confused! Help! -- If you are a patient please allow up to 12 hours for a reply by email/please note the new email address.Remember that e-mail may not be entirely secure/ MD ph fax Quote Link to comment Share on other sites More sharing options...
Guest guest Posted November 4, 2008 Report Share Posted November 4, 2008 What dx codes are you using? > > Quick question cause I am starting to get some medicare rejections. > > Coding for regular visit..99211-99213 depending on the situation. > code for vax: 90658 and adm G0008. > What about the modifiers? Do I put a -25 on the visit alone? Do I leave > out the -25 modifier? I am so confused! Help! > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted November 4, 2008 Report Share Posted November 4, 2008 use diagnosis code V04.81, need for flu immunizationfor medicare use G0008(administration) and 90658 (actual flu vaccine)if just doing vaccine use the two above both linked to same dx codefor commercial insurance use same dx code V04.81use 90471 for admin 90658 for the vaccineflumistuse 90473 for admin 90660 for the vaccine for flumist same dx code for medicare flumist I think you still use G0008 if doing a visit 99211,2,3,4,5 additionallythen put the 25 modifier on the visit code eg 99214-25To: From: gcdcajla@...Date: Tue, 4 Nov 2008 00:43:23 +0000Subject: Re: flu vax coding question What dx codes are you using? > > Quick question cause I am starting to get some medicare rejections. > > Coding for regular visit..99211-99213 depending on the situation. > code for vax: 90658 and adm G0008. > What about the modifiers? Do I put a -25 on the visit alone? Do I leave > out the -25 modifier? I am so confused! Help! > Get more out of the Web. Learn 10 hidden secrets of Windows Live. Learn Now Quote Link to comment Share on other sites More sharing options...
Guest guest Posted November 4, 2008 Report Share Posted November 4, 2008 use diagnosis code V04.81, need for flu immunizationfor medicare use G0008(administration) and 90658 (actual flu vaccine)if just doing vaccine use the two above both linked to same dx codefor commercial insurance use same dx code V04.81use 90471 for admin 90658 for the vaccineflumistuse 90473 for admin 90660 for the vaccine for flumist same dx code for medicare flumist I think you still use G0008 if doing a visit 99211,2,3,4,5 additionallythen put the 25 modifier on the visit code eg 99214-25To: From: gcdcajla@...Date: Tue, 4 Nov 2008 00:43:23 +0000Subject: Re: flu vax coding question What dx codes are you using? > > Quick question cause I am starting to get some medicare rejections. > > Coding for regular visit..99211-99213 depending on the situation. > code for vax: 90658 and adm G0008. > What about the modifiers? Do I put a -25 on the visit alone? Do I leave > out the -25 modifier? I am so confused! Help! > Get more out of the Web. Learn 10 hidden secrets of Windows Live. Learn Now Quote Link to comment Share on other sites More sharing options...
Guest guest Posted November 6, 2008 Report Share Posted November 6, 2008 99211 and the vaccine code and G0008 are mutually exclusive. Medicare won't pay for a 211 on the same DOS. All of the other office E & M codes should be paid as long as -25 added to the E & M code. Dr. Beth Sullivan, DORidgeway Family Practice, PCCommerce, GA flu vax coding questionTo: Date: Monday, November 3, 2008, 5:53 PM Quick question cause I am starting to get some medicare rejections.Coding for regular visit..99211- 99213 depending on the situation.code for vax: 90658 and adm G0008. What about the modifiers? Do I put a -25 on the visit alone? Do I leave out the -25 modifier? I am so confused! Help! Quote Link to comment Share on other sites More sharing options...
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