Wiki Tetanus Vaccine

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If done as a routine immunization done for preventive purposes, it is not a covered benefit under Part B. My understanding is that if it is administered as part of the treatment due to an injury that it would be covered.

I have also heard that the preventive service is covered by Part D as a pharmacy benefit but am not familiar with Part D billing so have no personal experience with this.
 
Yes I have read the same regarding Part D paying for routine vaccinations.
However, if patient was injured, I am still not getting reimbursed. I am using a cut, wound or puncture as primary dx.
 
dianaellis said:
Yes I have read the same regarding Part D paying for routine vaccinations.
However, if patient was injured, I am still not getting reimbursed. I am using a cut, wound or puncture as primary dx.
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What codes are you billing and what is your denial reason? There are of course a lot of different reasons that a claim can be denied.

If it's CO-50, then that would be for a diagnosis code that is not on the coverage list and you'd need to look at your local payer's policies. For example here is the CGS coverage article for KY and OH: CGS Tetanus LCA
 
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