News and Updates >> Client Update
November 1, 2009
Flu Season is Upon Us --- H1N1 Billing
The appropriate diagnosis for H1N1 vaccine is V04.81. You should also indicate any high risk applicable diagnoses
Medicare has stated in the Part B News Update, we should be billing G9142 for the vaccine itself, which should have a zero dollar fee associated as it is supplied by the Government. We should us G9141 for the administration of the H1N1 vaccine and this should have a fee associated with it.
Commercial Carriers don’t accept the G Codes that Medicare uses. So here’s how we should be billing the H1N1 vaccine to commercial carrier. We need to use 90663 (Influenza virus vaccine, pandemic formulation) and should have a zero dollar fee associated as it’s supplied by the Government. There is also a new CPT Code (effective 9.25.09) which was specifically created for the H1N1 administration. The code is 90470, immunization administration (intramuscular, intranasal), including counseling when performed. This CPT code should have a dollar amount attached
If you have a patient that presents in the office and is given the diagnosis of H1N1 after your final assessment please use diagnosis code 488.1. This information was obtained from a previous Medicare Part B News Update
Please do not hesitate to contact Peggy Camerlin at PhyLogic Healthcare with any questions at 877-273-3100.