Q&A Coding administration of injections for a Medicare pt

[Karen Wheeler]

I am preparing for the CPC exam will there be any questions like this on the exam that deal with Medicare?
Also I have tried to research this and only come up with information for 2013, do you know if there is an update for 2014?

A 65 y/o male patient presents to the office for influenza (Fluvirin) and pneumonia vaccines. The patient has Medicare as his primary payer (insurance carrier).

What are the proper codes & modifiers to bill this service?
a. 90471, 90656, 90742-59, 90732
b. 90471, 90656, 90471-59, 90732
c. G0008, Q2037, G0009-59, 90732
d. G0008, Q2037, G0009-51, 90732

ANSWER: C
Medicare uses HCPCS codes for the administration of injections. Therefore, you can eliminate A & B.
The proper modifier is 59 because you are using two different needles to administer the injections.
HINT: If you know insurance regulations, you can quickly code this scenario.


Thank you for your help
KarenWheeler

 

[Anne]

What I learned from our vendor, when ordering the flu vaccines earlier in the year was that the different strengths of the flu vaccine & suppliers, as well as single dose syringe vs vials would potentially change the codes TIV / QIV, etc.