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Preventive Services: Pneumococcal Vaccine and Administration

By:  Find-A-Code
Published:  September 1st, 2017

The following information from the Medicare Learning Network provides guidance from the Department of Health and Human Services on Pneumococcal Vaccine and Administration: 

HCPCS/CPT Codes

90670 - Pneumococcal conjugate vaccine, 13 valent (PCV13), for intramuscular use
90732 - Pneumococcal polysaccharide vaccine, 23-valent (PPSV23), adult or immunosuppressed patient dosage, when administered to individuals 2 years or older, for subcutaneous or intramuscular use
G0009 Administration of pneumococcal vaccine

ICD-10 Codes

Z23

Who Is Covered

All Medicare beneficiaries

Frequency

  • An initial pneumococcal vaccine to Medicare beneficiaries who never received the vaccine under Medicare Part B
  • A different, second pneumococcal vaccine 1 year after the first vaccine was administered

Medicare Beneficiary Pays

  • Copayment/coinsurance waived
  • Deductible waived

Other Notes


Please note: The information in this educational product applies only to the Medicare Fee-For-Service Program (also known as Original Medicare). For additional guidance on using diagnosis codes, go to the Medicare Claims Processing Manual, Chapter 18 on the Centers for Medicare & Medicaid Services (CMS) website.

Watch the CMS Provider Minute: Preventive Services video for pointers to help you submit sufficient documentation when billing for certain preventive services.


References:

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