# Billing Influenza



## lisa dixon (Sep 8, 2010)

I would like to see how others are filing influenza to Medicare and private insurance.  

Example: Patient comes in as flu shot only (90658,G0009).

How do you file Medicare patient in office for other exam (99214, 401.9,428.0, 493) at the visit the provider decides to give a flu vaccine, and also for a commercial insurance.

I have heard to charge 90471 to commercial for administration even if patient is seen and to add modifier 25 to Medicare claims with the appropriate V code.

At the same time I have heard not to bill 90471 or modifier 25.  

Thanks in advance for your replys.


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## nishwitzp (Sep 10, 2010)

*flu vaccine*

medicare with no visit:  90658  or 90662(for new High dose vaccine)  and G0008
            G0009 is for administration of Pneumonia vaccine

medicare with a OV  use the 25 modifier on the E & M code with diagnosis for the visit 
          and flu shot same as above with the ICD-9, V04.81, code on flu vaccine codes

for commercial product   no office visit
       use the CPT code that matches the vaccine you are using
       90655 - 90662     and  immunization administration code 90471

for commercial product  with office visit
       may need to ck with insurance company 
       but I usually do the  OV with 25 modifier with appropiate diagnosis linked to it
       and flu shot (again cpt that matches the vaccine you are using) and the                      administration  code 90471 or use the with counseling administration code if indicated.
     I have heard that you can use a SK modifier on the flu vaccine (not the administration code)if the pt is a High risk  (ie asthmatic)  for commercial products


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