Can 90471 be billed to Medicare?

For Medicare, the use G codes is very common for billing specific procedures. There are also more procedures codes used along with G codes for vaccination like CPT code 90471, +90472, 90473, +90474 which we will checkout one by one.

How do I bill CPT 90471?

CPT 90471 and CPT 90473 must be billed with a unit value of “1.” Code the vaccine product code with the applicable diagnosis code and the EP modifier. Code the applicable add-on vaccine administration code (CPT 90472 or 90474) with the appropriate number of units, the diagnosis code and the EP modifier.

What is the administration code for 90471?

Initial administration codes include: 90471: Immunization administration for percutaneous, intra-dermal, subcutaneous or intramuscular injections, initial. 90473: Immunization administration for intra-nasal or oral route, initial.

What is the administration code for flu vaccine for Medicare?

Flu Shot Coding

Administration & Diagnosis Codes	Vaccine Codes & Descriptors
90686	Influenza virus vaccine, quadrivalent (IIV4), split virus, preservative free, 0.5 mL dosage, for intramuscular use
90687	Influenza virus vaccine, quadrivalent (IIV4), split virus, 0.25 mL dosage, for intramuscular use

How many times can you bill 90471?

90471-90474 are reported per vaccine, rather than per vaccine component. Report 90471 and 90473 are for the initial or first vaccine administered, depending on the route of administration. You may use only one initial administration code per patient encounter.

Does CPT 90471 need a modifier?

If 90471 does not represent a duplicate of the service described by HCPCS code, modifier 59 may be to the 90471 code. In addition a diagnosis code specific to the disease for which the prophylactic vaccine is being administered, it should be linked to 90471….Modifiers.

CPT Code	CPT Code(s)
90473	90460, 90471

Does CPT code 90471 need a modifier?

What is the CPT code for administration of injections?

96372
96372 CPT code: Administration and Injection coding guidelines.

How do I bill Medicare for flu shot 2021?

When reporting vaccination encounters, use ICD-10-CM diagnosis code Z23 Encounter for immunization. For Medicare, code the administration of the flu shot with G0008 Administration of influenza virus vaccine.

What is the CPT code for Flu Vaccine 2020 2021?

Payment Allowances and Effective Dates for the 2020-2021 Flu Season:

Code	Labeler Name	Vaccine Name
90688	Sanofi Pasteur Seqirus	Fluzone Quadrivalent (2020/2021) Afluria Quadrivalent (2020/2021)
90756	Seqirus	Flucelvax Quadrivalent (2020/2021)

Can you bill a nurse visit with a flu vaccine?

Nope we are not allowed to do that for any vaccination, or injection.