tci Part B Insider - 2009 Issue 30

IMMUNIZATIONS: Correctly Predict Tetanus Injection Coverage

Medicare won't always reimburse tetanus vaccines, but there are exceptions. Think getting Medicare to pay for tetanus shots is like taking a shot in the dark? The medical necessity for providing a tetanus shot can unlock coverage. Here are a few easy-to-follow steps to sharpen your tetanus coding, and obtain the reimbursement you deserve. Step 1: Consider Preventive Shots Noncovered If the patient needs only a booster shot of his tetanus vaccine, unrelated to injury or illness, it is not covered under Medicare Part B. The Medicare Benefit Policy Manual, Chapter 15, Section 50.4.4.2, states that...

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