tci Medicare Compliance & Reimbursement - 2021 Issue Q4

Industry Notes: Part B MAC Reports Flu Vaccination Claims Issues Are on the Rise

Even though the 2021-2022 flu season just commenced on Aug. 1, one Medicare carrier is already seeing an abundance of vaccination claims with the wrong CPT® codes. Details: “National Government Services has noticed a large amount of claims being billed for the 2021-2022 flu season with the incorrect CPT® codes for influenza flu vaccines,” the Part B Medicare Administrative Contractor (MAC) notes in a Sept. 27 release. The National Drug Codes (NDCs) change annually, too, and they “must be included in Loop 2410 LIN segments of the electronic claim (Item 19 on the CMS-1500 paper claim)...

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