Pharmacy Question for the Week of June 18, 2018

Pharmacy Compliance Question of the Week

Question:

We (hospital) are looking for billing instructions related to roster-billing for the influenza virus vaccine and the pneumococcal vaccine provided to inpatients. Can you provide any guidelines?

Answer:

According to the Medicare Claims Processing Manual, section 10.3.2.2, the following billing instructions apply:

  • Hospitals do not have to wait until patients are discharged to provide the vaccine. They may provide it anytime during the patient’s stay.
  • The roster should reflect the actual date of service.
  • The requirement to provide the vaccine to five or more patients at the same time to meet the requirements for mass immunizers is waived when vaccines are provided to hospital inpatients. Therefore, the roster may contain fewer than five patients or fewer than five patients on the same day.
  • The roster should contain information indicating that the vaccines were provided to inpatients to avoid questions regarding the number of patients or various dates.

Disclaimer: Every reasonable effort was made to ensure the accuracy of this information at the time it was published. However, due to the nature of industry changes over time we cannot guarantee its validity after the year it was published.