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Hello all. I bill for a Family Practice. Is the a specific "G" code to bill Medicare plans for the administration of Shingrix- 90750? I know for flu it's G0008 and pnuemoccal G0009.
There is no G-Code for Shingrix. This should be billed through Part D.
Medicare Part B provides preventive coverage only for certain vaccines. These include:
Influenza: once per flu season (codes 90630, 90653, 90656, 90662, 90673-74, 90682, 90685-88, 90756, Q2035, Q2037, Q2039)
Pneumococcal: (codes 90670, 90732, once per lifetime with high-risk booster after 5 years)
Hepatitis B: for persons at intermediate- to high-risk (codes 90739- 90740, 90743-90744, 90746-90747)
Administration services for these preventive vaccines are reported to Medicare using HCPCS codes as follows:
G0008 administration of influenza virus vaccine
G0009 administration of pneumococcal vaccine
G0010 administration of Hepatitis B vaccine
The diagnosis code to report with these preventive vaccines is:
Z23 Encounter for immunization
Other immunizations are covered under Medicare Part B only if they are directly related to the treatment of an injury or direct exposure (such as antirabies treatment, tetanus antitoxin, or booster vaccine, botulin antitoxin, antivenin, or immune globulin)
Coverage of other vaccines provided as a preventive service may be covered under a patient's Part D coverage.