Roster Billing

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 Medicare requirements in order to use the roster billing method. Mass immunizers A mass immunizer is defined as any entity that gives the influenza virus vaccine or…

Seasonal Influenza Virus, Pneumococcal and Hepatitis B – FAQs

Seasonal Influenza Virus, Pneumococcal and Hepatitis B – FAQs

Does a Part B deductible or coinsurance apply to adult immunizations covered by Medicare? Neither a Part B deductible nor coinsurance applies to the seasonal influenza virus or pneumococcal vaccines and their administration. The Part B deductible, plus the 20 percent Medicare coinsurance amount, applies to the hepatitis B vaccine for all dates of service…

Payment for Influenza Vaccines

Payment for Influenza Vaccines

Effective for claims with dates of service on or after January 1, 2011, the following CPT code will no longer be payable for Medicare: CPT 90658 Influenza virus vaccine, split virus, when administered to individuals 3 years of age and older, for intramuscular use. Effective for claims with dates of service on or after October…

Coding guidelines for Haemophilus influenzae type b conjugate vaccine

Coding guidelines for Haemophilus influenzae type b conjugate vaccine

CDC – Childhood Immunization Schedule – Haemophilus influenzae type b conjugate vaccine Haemophilus influenzae type b conjugate vaccine (Hib) – Minimum age: 6 weeks • If PRP-OMP (PedvaxHIB® or ComVax® [Merck]) is administered at ages 2 and 4 months, a dose at age 6 months is not required. • TriHIBit® (DTaP/Hib) combination products should not…

Coding guidelines for seasonal Influenza, H1N1 (swine flu) and Pneumococcal vaccines

Influenza – An acute febrile highly contagious viral disease caused by RNA viruses that affects birds and mammals. Yearly vaccination would be the best way to prevent seasonal FLU. CDC’s National Immunization Program (NIP) recommends the high risk persons to get immunized against Influenza if a person is in any of the following category: 1. Children…

Swine Flu Coding

Swine Flu Coding

Coding information pertaining to the Swine Flu (H1N1) virus vaccination and its administration has been published on the AMA website. Please follow the link to know more http://www.ama-assn.org/ama1/pub/upload/mm/362/vaccine-codes.pdf