Bc/Bs of MA 90658 administration cpt

[hpalomo]

The physician I bill for always put G9141 for an administration code for the flu vacc (90658), so I always entered it that way assuming he was administering the H1N1 Vaccine.  Come to find out it's not the H1N1 he's administering, it's the regular flu vaccine.  I started billing 90471 for adult admin and now BcBs isn't paying at all on that code stating it's included in payment for the primary office visit.  That's with or without a 25 on the office visit.  I got paid almost $40 for the admin for the G9141 and now nothing on the 90471.  Is that correct?  Why would they pay for the G9141 and not 90471?  Doesn't seen right.  Anybody know???

Thanks in advance for your input,
Heather/Tewksbury MA

[Michele]

Have you tried talking to the BC provider rep?  I would start there. 

[billingandscanning]

Check these out and maybe it will help you, or as Michelle said you can call BSBS of MA.

http://www.ama-assn.org/resources/doc/cpt/ama-fact-sheet-report-cpt-codes-influenza.pdf

http://www.massmed.org/AM/Template.cfm?Section=Public_Health_Resources&CONTENTID=31464&TEMPLATE=/CM/HTMLDisplay.cfm

Good Luck!

[hpalomo]

Thanks for your help.  I did find out that the H1N1 is included in the seasonal flu vaccine, I'm wondering in that case, if I'm getting denials for the admin code 90471 for flu vaccine 90658 and getting paid for G9141 (admin H1N1) if I can continue using it.  H1n1 is part of this vaccine.  What do you think?

Heather

[Michele]

This might help:  http://www.capturebilling.com/2011-medicare-codes-for-flu-shots-q2035-q2036-q2037-q2038/

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