tci Medicare Compliance & Reimbursement - 2019 Issue 12

Industry Note: Don’t Forget Zip Codes When Submitting Flu Vaccine Claims

Claims for services outlined and payable under the Medicare Physician Fee Schedule (MPFS), like flu vaccines, must include the zip code locality, reminds one Medicare Administrative Contractor (MAC). Part B MAC NGS Medicare recently discovered that the payment in Massachusetts for three flu vaccine codes would be updated and figured differently according to the two distinct facility localities. The following HCPCS codes are impacted: G0008 (Administration of influenza virus vaccine) G0009 (Administration of pneumococcal vaccine) G0010 (Administration of hepatitis B vaccine). Because the two locations refer to the greater metropolitan area of Boston (01 locality) and the remainder of...

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