2011-2012 SEASON INFLUENZA. August 2011 ITV Training Presented by: Janet Overstreet DPH/AFM/LHO August 30, 2011.
Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author.While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server.
August 2011 ITV Training
Presented by: Janet Overstreet
August 30, 2011
For LHDs administering, coding and reporting the influenza vaccine/administration through PSRS/CMS Portal: --KVP received influenza vaccine (VFC and other KVP provided vaccine)or--Private purchased influenza vaccine
Removal of “nominal” fees
Reporting of “vaccine administration” codes
Due to Medicaid requirements, nominal fees cannot be charged to some patients and Medicaid be charged at a higher rate.
How does this affect what information we collect from the patient and report in the system?
There has been added fields to collect:
Number in Household
Income or Income NOT Given
This will be important for:
Self-Pay KVP/VFC eligible patients (if not reporting as Fixed-Full Charge)
Other than KVP, if you provide flu shots to patients on a Sliding Fee
If the patient does not complete these fields, you may
use: 1 - for number in household
99999 - for income or income not given
If your agency chooses not to take income, blank out the Income fields on the
Vaccine Administration form and use 99999 as Income for patients you will
not be doing as a Fixed-Full Charge. You will need to assure this does not pose
issues for established patients who are participating in other LHD programs.
May be used for patients for which your agency purchased private stock vaccine and does not have a third party payor being billed
Income will not effect the charge; with the exception of Insurance co-pays (we are working with CDP to try and get that corrected)
FFC may be used for reporting Self-Pay KVP/VFC eligible patients, however, they cannot be charged more than $14.17 for the administration; DPH will approve an over-ride rate rounded to $14.00
CANNOT report an Evaluation/Management visit if the patient only receives a flu shotWhile receiving a flu shot, if the patient receives and additional service requiring an E/M reported for different diagnosis code; the E/M will need to be reported with a 25 modifier.
When reporting the G0008 administration code, the 80000 pseudo procedure code will not be needed.When reporting the 90460, 90471 or 90473 administration codes, the 80000 will be needed.When coding by component you will need to review the VIS form thoroughly with the patient/parent/legal guardian, discuss the risk, benefits and side effects and document that you counseled per component.
Send your request to the Local Health Help Desk at LocalHealth.HelpDesk@ky.gov
Request for Influenza administrationshould be no less than $18.00 if your agency is billing Medicaid (except for KVP eligible patients cannot be charge more than $14.17 per immunization)
LHDs may request Private dose Influenza Vaccine at a lesser rate than the recommended DPH rate