Author Topic: H1N1 BILLING  (Read 1403 times)


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« on: November 23, 2009, 11:35:28 AM »
I have been having trouble billing for the H1N1 vaccination. Does anyone know anything about where how to bill for the vaccination?

I've billed commercial insurances and state insurances with 90663-SL with ICD-9 V04.81 with an administration code 90470 and have been getting denials from insurances for the administration fee. Should I be billing with 90663-SL along with G9141-SL or G9142-SL?

Also, when a patient comes in for an offive visit not relating to the vaccination and then gets the H1N1 vaccination, would I have to use the modifier 25 with the offive visit cpt code? Please help!


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« Reply #1 on: November 23, 2009, 04:51:32 PM »
Different carriers want it billed different ways, some want the 90663 with a 0.00 charge since the vaccine is free and if your clearinghouse won't accept $0.00 you can put $0.01 .  Other carriers like Medicare want the G9141 Payment will be the same as for the administration of the seasonal Influenza virus vaccine however Since the H1N1 vaccine will be made available at no cost to providers, Medicare will not reimburse for the vaccine. According to Medicare you do not need to put the G9142 code as it will not be paid.  You will have to call the commercial carriers to see how they want it billed. Some of them have instructions on their websites.
Linda Walker
Practice Managers Resource & Networking Community
One Stop Resources, Education and Networking for Medical Billers