Wiki Billing for 99211

[hopkins441]

We recently began billing for another Doctor's office, they are wanting to put a 99211 on all of there Flu shot charges. We don't know if this is acceptable to bill this, without the nurse consulting the Doctor. If anyone could give us some guidance, it would be appreciated. Thank you Kristi

 

[ebredehoeft]

It is my understanding that if they were only coming in for the flu shot that you could only bill the vaccine plus the administration. Please let me know if I am wrong about this.

 

[cheermom68]

99211

You are exactly right.
LeeAnn

 

[ohn0disaster]

If the patient is coming in for the purpose of getting a flu shot, it should be coded as follows; V04.81, 90471, 90658.

1 Billing for Additional Services

If a physician sees a beneficiary for the sole purpose of administering the influenza virus vaccine, the pneumococcal vaccine, and/or the hepatitis B vaccine, they may not routinely bill for an office visit. However, if the beneficiary actually receives other services constituting an “office visit” level of service, the physician may bill for a visit in addition to the vaccines and their administration, and Medicare will pay for the visit in addition to the vaccines and their administration if it is reasonable and medically necessary.

http://www.cms.gov/manuals/downloads/clm104c18.pdf

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