Author Topic: G0008 with G0009  (Read 2804 times)

datwood

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G0008 with G0009
« on: October 25, 2013, 07:02:07 PM »
Hi - Help!!! When I send in charges to Medicare for pneumo and flu vaccines we are getting paid on it, however, the g-codes are not getting paid..  I use G0008 v04.81 and G0009 V03.82.  I called Medicare and they said I need a modifier in order for the doctor to get paid.  What modifier code do I use?  Also, I looked up seasonal influenza virus and pneumococcal vaccine do I use G0008 and G0009 with V06.6.  Is the doctor going to get paid on both G codes?

Please if someone could please please let me know so that I can resend my claims. 

Thank you and blessings,
Dolores

shanbull

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Re: G0008 with G0009
« Reply #1 on: November 06, 2013, 10:37:46 AM »
You're doing everything right as far as I can tell, and yes the Dr. gets paid for all the codes. And yes if you're billing both G0008 and G0009 in the same visit, the Dx code should be V06.6 for both.

Since our office only bills for the flu vaccine most of the time, and doesn't use a modifier and still gets paid, I think they may want you to add a modifier separating the vaccine administrations as distinct procedures, which would be modifier 59 for both. If there is also an E&M service performed at the appointment, you will need to use a modifier 25 for the E&M code.

I found some extra info here: http://codapedia.com/articlePrint.cfm?id=485

If you're still getting denials, please post again.