How do we code for an office visit with a flu shot and pneumonia shot? Do we need to use a modifier?
Question: How do we code for an office visit with a flu shot and pneumonia shot? Do we need to use a modifier?
Answer: According to expert coder Emily Hill of Hill & Associates, the flu shot is reported with either 90656 or 90658 (over age 3) depending on whether or not it is preservative-free. G0008 is the administration code for Medicare. The administration code for other payers is 90471-90472, unless they have stated otherwise.
Use 90732 for the pneumococcal vaccine product. G0009 is the administration code for Medicare. 90471-90472 would be reported to other payers.
If you gave both shots to the same non-Medicare patient, you would bill the administration as 90471 and 90472 plus the vaccine products. 90471 is for the first vaccine and 90472 is an add-on code for each additional vaccine.
If you also provided a distinct E&M service unrelated to the vaccine, it would be reported separately. A modifier is not required.
For example: Non-Medicare patient: 90658, 90732, 90471, 90472, 99213; Medicare patient: 90658, 90732, G0008, G0009, 99213.
Asset Protection and Financial Planning
December 6th 2021Asset protection attorney and regular Physicians Practice contributor Ike Devji and Anthony Williams, an investment advisor representative and the founder and president of Mosaic Financial Associates, discuss the impact of COVID-19 on high-earner assets and financial planning, impending tax changes, common asset protection and wealth preservation mistakes high earners make, and more.