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Does anyone know what CPT code to use for administration of a flu vaccine for Medicaid of CT. We use 90471 and it get's denied. They only pay for the flu vaccine. We administer to adults only. Thanks.
If the admin is done by a nurse, you might be able to use the 99211 (in lieu of the admin code) (for Maryland Medicaid, that is what they instruct the Providers to do) or if the Provider saw the patient on the same day, code the office visit with 25 mod as necessary and the vaccine. Most medicaid's will not pay for the administration of the Flu Vaccine. Medicare requires G0008 for the flu, G0009 for pneumonia . and G0010 for HepB administration codes in lieu of the 90471. I would also suggest going online or calling Provider Rep and asking them the same question since different states have different guidelines. Most Medicaid's will have some sort of guidance listed under their Vaccine and Injectables policy. I would start there first. I hope this helps.