Primary Care Coding Alert
Q2038, G0008 Is Acceptable Fluzone Pairing for Medicare Patients
Question: Medicare denies our claims for flu vaccines with claim status codes of 254 and 255, which indicate problems with the principal diagnosis code. We are using Q2038 for Fluzone and G0008 for the administration, as we have done since 2011. We are also still using V04.81 as the principal (and only) diagnosis code. What is the problem?
Answer: Codes Q2038 (Influenza virus vaccine, split virus, when administered to individuals 3 years of age and older, for intramuscular use [Fluzone]) and G0008 (Administration of influenza vaccine) are valid HCPCS codes for 2013, and V04.81 (Need for prophylactic vaccination and inoculation against influenza) is an acceptable supporting diagnosis. HCPCS and CPT® have different codes for various categories of Fluzone vaccine administration. Double check the category of drug that your practitioners are administering to be sure you’re reporting the correct one. If so, you might need to follow up with your Medicare contractor to understand and correct the denial.
New York Subscriber
Primary Care Coding Alert
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