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Does Medicare pay for 90670?

Does Medicare pay for 90670?

Medicare Part B provides preventive coverage only for certain vaccines. These include: Influenza: once per flu season (codes 90630, 90653, 90656, 90662, 90673-74, 90682, 90685-88, 90756, Q2035, Q2037, Q2039) Pneumococcal: (codes 90670, 90732, once per lifetime with high-risk booster after 5 years)

How do I bill for pneumonia vaccine?


  1. 90670: Pneumococcal conjugate vaccine, 13-valent, for intramuscular use.
  2. 90732: Pneumococcal polysaccharide vaccine, 23-valent, adult or immunosuppressed patient dosage, when administered to individuals two years or older, for subcutaneous or intramuscular use.
  3. G0009: PPV administration.

What is roster billing?

Roster billing is a simplified billing process that allows mass immunizers to submit one claim with a list of the members they immunized. Mass immunizers must meet Original Medicare1 requirements in order to use the roster billing method for Medicare Plus Blue plans.

What is the CPT code for Shingrix?


CPT Code (Product): 90750
CPT Code (Administration) 1 vaccine administered: Each additional vaccine administered during same encounter: 90471 90472
ICD-10-CM Code (Encounter for Immunization): Z23
Administration Modifier for Medicare: GY

How do I get reimbursed for shingles vaccine?

If your doctor can’t bill your plan directly, ask your doctor to coordinate with an in-network pharmacy. The pharmacy might be able to give you the vaccine and bill your plan directly. File your vaccine bill for reimbursement with your plan if you can’t do either of the options above.

Is CPT 90694 covered by Medicare?

Note: Effective with dates of service on or after July 1, 2020, flu vaccine code 90694 (Influenza virus vaccine, quadrivalent (aIIV4), inactivated, adjuvanted, preservative free, 0.5 mL dosage, for intramuscular use) is payable by Medicare.

What is the CPT code 90670?

Pneumococcal conjugate vaccine

HCPCS / CPT Description
90670 Pneumococcal conjugate vaccine, 13 valent, for intramuscular use
90732 Pneumococcal polysaccharide vaccine, 23-valent, adult or immunosuppressed patient dosage, for use in individuals 2 years or older, for subcutaneous or intramuscular use;

What is Revenue Code 0771?

Administration is billed under revenue code 0771, which is for Vaccine Administration under the Preventative Care Services category, even though this drug or combination of drugs is not technically a vaccine. Condition code A6 (Vaccines/100% Medicare Payment). Diagnosis code Z23 (Encounter for Immunization).

Can you bill G0009 and 90471 together?

Description of HCPCS code G0008, G0009, G0010 & CPT code 90471, 90472, 90473, +90474. The HCPCS administration codes and the vaccine codes have a one-to-one relationship and are always paired together. Rules for reporting initial or subsequent vaccines do not apply.

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