Home Health & Hospice Week

You may need to adjust your claims.

A coding mix-up could be subjecting you and your patients to inaccurate cost sharing.

The problem: HHH Medicare Administrative Contractor CGS “has seen that some providers are incorrectly reporting HCPCS code 90471 for the administration of the influenza vaccine,” the MAC explains on its website. “HCPCS code 90471 is for outpatient prospective payment system (OPPS) hospitals billing the hepatitis B vaccine administration. When 90471 is reported by home health and hospice providers, the Fiscal Intermediary Standard System (FISS) applies coinsurance and deductible.”

The solution: Home care providers should submit G0008 for flu vaccinations. “If you have submitted HCPCS 90471 for the administration of the influenza flu vaccine on home health claims (341 type of bill) or hospice claims (81X or 82X type of bill), you will need to submit an adjustment to change the HCPCS code to G0008 in order to remove the coinsurance and deductible amounts,” CGS instructs.