Specs:
Noridian MAC
Not a Mass Immunizer
Not a Roster Billing
Not RHC or FQHC facility
CPT/HCPCS: 90674 (Influenza)/G0008 (Administration)
Dx: Z23
TOB: 131
Condition code: A6
Medicare Denial RARC code: 45
Claims submitted individually via UB-04 w/TOB 131.
We are billing Medicare for immunization, example seasonal influenza. Got Medicare Remittance Advice denial code of RARC-45, charge exceeds fee schedule/maximum allowable or contracted/legislated fee arrangement. Not clear what we are missing, any suggestions/ideas? Thanks in advance!