# Medicaid H1N1 Coding



## ddiec (Nov 22, 2009)

Hi,

Had anyone coding H1N1 for Medicaid yet? What CPT and ICD 9 code that you used? Is Medicaid pay? My claims got rejected as reason: invalid!!!  Due to I used CPT code G9141 for injection administration. Can anyone tell me?Thank you.

Dawn


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## skiboi (Nov 22, 2009)

*H1N1 medicaid adm*

I believe that you should only be using 90470 to bill adm of H1N1 to Medicaid. The 'g' code you submitted should only be used for MEDICARE claims. Anyone can correct me if I'm wrong.


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## neha.bhatnagar (Nov 23, 2009)

I agree. You should only use 90470 for Medicaid as G codes are used for Medicare.


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## mitchellde (Nov 23, 2009)

The G codes are definitly for Medicare, however they are designated as carrier discretion use so other carrier could use the G if they wish, sounds like your Medicaid does not wish.


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## kim cpc (Nov 23, 2009)

*H1N1 with Medicaid & other carriers*

We are using G9142 with DX V04.81, and no administration charge for medicaid patients, for all other insurances we are using 90470 with 90663 and the DX of V04.81

Good Luck to everyone on getting paid


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## gailmc (Nov 23, 2009)

Our Medicare and Medicare replacement products require the G codes, but the rest of our payers including Medicaid will accept either G codes or CPT codes.


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## jod867 (Dec 1, 2009)

For medicaid we are doing 90663 with $.01 for the charge and 90470 for the admin. You aren't allowed to charge for the vaccine itself because its government funded. but you should get paid for the Admin. My system rejects the 90470 as a invalid code but medicaid does pay for it. also the DX code is the V04.81 as stated above. I hope that helps.


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## Kirstyn20 (Dec 2, 2009)

jod867 said:


> For medicaid we are doing 90663 with $.01 for the charge and 90470 for the admin. You aren't allowed to charge for the vaccine itself because its government funded. but you should get paid for the Admin. My system rejects the 90470 as a invalid code but medicaid does pay for it. also the DX code is the V04.81 as stated above. I hope that helps.




That is all correct except the dx is 488.1


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## mitchellde (Dec 2, 2009)

Kirstyn20 said:


> That is all correct except the dx is 488.1



488.1 is the dx code for patients with confirmed H1N1 virus dx.  NOT for the vaccine admin.  That is the V04.81.  DO NOT give the patient the dx of having the H1N1 virus when they do not!


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## pammalou (Dec 12, 2009)

the V04.81 is definately correct, not the 488.1 as you stated


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## LOVE2CODE (Dec 12, 2009)

jod867 said:


> For medicaid we are doing 90663 with $.01 for the charge and 90470 for the admin. You aren't allowed to charge for the vaccine itself because its government funded. but you should get paid for the Admin. My system rejects the 90470 as a invalid code but medicaid does pay for it. also the DX code is the V04.81 as stated above. I hope that helps.



THIS INFORMATION IS SOLEY CORRECT.....This is how we are billing and we are getting paid...


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## mitchellde (Dec 13, 2009)

Everyone does realize I hope that the 90470 is a CPT code that was deleted in 1999, and the problem with the payers rejecting it as invalid is that the electronic system did not get the message that the code was revitalized on Sept 28th to be for the admin of H1N1.  You will need to communicate this with some payers so they can fix the edits.  This is why some get an edit for invalid code.


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