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Don’t Let Your Flu Vaccination Claims Deny!

The 2023-2024 flu vaccine season has begun.

At the beginning of each flu season, National Government Services sees an increase in claim denial volume for flu vaccinations. This notice is being issued as a reminder of the specific billing requirements for flu vaccinations for our Part B providers.

  1. Use current year coding and pricing.
    • Each flu season, CMS publishes the current year allowed vaccine codes, and their pricing to their website: Seasonal Influenza Vaccines Pricing
    • All Part B providers must use one of the codes from this list
    • Codes not on the current year list are not valid and claims will deny
  1. Flu vaccine claims submitted to Medicare Part B must include the NDC.
    • The NDC is on the box of vaccine you received from the manufacturer
    • NDCs change each flu season
    • The NDC must be added to loop 2410/Segment LIN of the Medicare electronic claim
      • Item 19 of the paper claim
  1. G0008 is the only administration code allowed on Medicare Part B claims.
    • Claims with a different HCPCS code for flu administration will deny
  2. Use our instructions for billing flu vaccine and administration to prevent denials

Posted 9/8/2023