Medical Billing Forum

Coding => Coding => Topic started by: dina716 on October 19, 2009, 09:45:00 PM

Title: Billing for Meningococcal vaccination and administration
Post by: dina716 on October 19, 2009, 09:45:00 PM
Can anyone please help me - I've been researching for about four hours now and I give up.   :'(

Patient sees physican in Rockland County, NY
Patient has UHC EMPIRE PLAN
Patient in for Office Service:  99203 (New Pt. Moderate)
Patient diagnosis':  477.9  Allergic Rhinitis and 519.11 Acute bronchospasm

Patient needs and gets:
Meningococcal vaccination and administration of said vaccine.

My research has led me to 'assume' it is: 
90471 (first immunization given during a single patient encounter);
then...
90734 Meningococcal conjugate vaccine, serogroups A, C, Y, and W-135 (tetravalent), for intramuscular use (Menactra)  OR...
90733 Meningococcal polysaccharide vaccine, for subcutaneous use (Menomune)
with...
V03.89 (Need for prophylactic vaccination and inoculation against bacterial diseases; other specified vaccinations against single bacterial diseases; other specified vaccination)

But I'm not sure because then I read something about a "G" code too.  Can anyone help me?   :-\
Title: Re: Billing for Meningococcal vaccination and administration
Post by: Michele on October 20, 2009, 07:43:07 AM
I would go with the codes you have listed.  You could call UHC/Empire Plan and ask them which one they prefer, but usually they go with CPT codes.

Michele
Title: Re: Billing for Meningococcal vaccination and administration
Post by: dina716 on October 20, 2009, 07:53:10 AM
And what about a G code?  Do you think I need that?

And thank you so much for getting back to me.   :)
Title: Re: Billing for Meningococcal vaccination and administration
Post by: Michele on October 20, 2009, 11:15:57 AM
You will only need that if that is what the specific insurance carrier requires.  I would go with the others, but if denied, it may be the G code they are looking for.

Michele