Pulmonology Coding Alert

Question: Do I need a physician to administer a flu or pneumonia vaccine?

Minnesota Subscriber  
Answer: The Medicare flu- and pneumonia-billing guide published by your local Medicare Part B carrier describes how to report these services. A physicians order and supervision are not required for a flu vaccine. Use codes G0008 (administration of influenza virus vaccine when no physician fee schedule service on the same day) and 90658-90660 (influenza virus vaccine).
 
However, a pneumonia vaccine requires a physicians order and supervision and is coded G0009 (administration of pneumococcal vaccine when no physician fee schedule service on the same day) and 90732 (pneumococcal polysaccharide vaccine, 23-valent, adult or immunosuppressed patient dosage, for use in individuals 2 years or older, for subcutaneous or intramuscular use).
 
The pneumonia vaccine is generally administered once to a person age 65 or older to confer lifetime protection. But an immunocompromised patient may receive a booster dose five years after the original vaccine. Flu shots are generally given in October or November but may be administered throughout the flu season, which usually ends in March.