tci Medicare Compliance & Reimbursement - 2014 Issue 8

Medicare Immunizations: Know When to Bill for Tetanus Shots

Tip: Prove medical necessity rather than preventive service. If you have been puzzling over whether or not Medicare reimburses tetanus shots, you are not alone. Here’s the lowdown on when you can expect to be paid and when your claim will be rejected. When administered as a preventive vaccine, Medicare does not cover a tetanus shot. However, if the patient needs a tetanus injection to treat a wound, you’ve hit coverage criteria. “Tetanus shots that don’t contain pertussis (whooping cough) are covered by Medicare Part B only when you’ve been injured or directly exposed...

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