tci Part B Insider - 2013 Issue 44

Medicare Immunizations: Don't Expect CMS to Cover Tetanus Shots Unless You've Been Injured

Get familiar with Medicare’s rules from medical necessity to choice of products. You could sit on the phone with your MAC for hours trying to determine how to collect for administering a tetanus shot, or you could simply ask one quick question: Is there an injury? 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...

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