Modifications in vaccine administration codes may mean fewer reimbursement hassles for physicians.
Specifically, CMS has revised the descriptors for codes G0008, G0009 and G0010 so that codes are now billable when a patient receives a Medicare-covered vaccine along with a noncovered vaccine. The change will remove the current restriction that prevents payment of some vaccine administration "G" codes when those codes are submitted with other appropriate physician fee schedule services.
The coding edits go into effect Jan. 1; CMS will update its Web site to reflect the changes on that date.
Note that physicians who previously were denied payment for the administration fee of a non-covered vaccine given on the same day as a covered vaccine may refile those denied claims for reprocessing after Jan. 1.
Another revision applies to vaccine administration codes for vaccinations provided on the same date as an office or outpatient visit. The change: All vaccine codes will be bundled with code 99211 (an office visit that may not require the presence of the physician).
In addition, all other evaluation and management services may be reported on the same date as a vaccine administration as long as the E/M service is significant and separately identifiable (use modifier 25).
Direct coding questions to Cynthia Hughes, AAFP coding and compliance specialist, by e-mail to chughes@aafp.org or by phone at (800) 274-2237, Ext. 4176.
