# Medicare Vaccine billing help



## suishay (Apr 5, 2011)

Please help!!  

Medicare Patient brought in Zostavax vaccine for our nurse to administer.  I sumbitted the claim with 99211, 90736 - $0, and V04.89, but the claim was on hold in our system because "If a physician sees a beneficiary for the sole purpose of administering the influenza virus vaccine, the pneumococcal vaccine, and/or the hepatitis B vaccine, they may not routinely bill for an office visit. " 

Can someone help me figure out how we can bill for this? Thank you very much!!


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## mitchellde (Apr 5, 2011)

you cannot bill a 99211 to administer an injection of any kind you use the injection administration code and vaccines have specific vaccine administration codes.


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## suishay (Apr 6, 2011)

So this claim is not billable?


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## mhoward@myhjc.com (Apr 6, 2011)

I've come across this with a different injection before. Try doing the Zostavax code for $0, and then the appropriate injection code (I'm in chiro now and can't remember what it is!  ) Good luck!


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## mitchellde (Apr 6, 2011)

no you will need to change the 99211 to a vaccine administration code such as 90471.


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## eadun2000 (Apr 6, 2011)

suishay said:


> Please help!!
> 
> Medicare Patient brought in Zostavax vaccine for our nurse to administer.  I sumbitted the claim with 99211, 90736 - $0, and V04.89, but the claim was on hold in our system because "If a physician sees a beneficiary for the sole purpose of administering the influenza virus vaccine, the pneumococcal vaccine, and/or the hepatitis B vaccine, they may not routinely bill for an office visit. "
> 
> Can someone help me figure out how we can bill for this? Thank you very much!!



You do not code a 99211 for a vaccine only.  It is included in the administation, which by the way you left off.  You need to code 90471 for the admin of the vaccine.


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## suishay (Apr 18, 2011)

Thank you very much for all of your helps


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