Originally, Medicare paid for the E/M, flu shot and admin (G0008), and denied the tetanus shot/admin (90471). We sent in an appeal for the tetanus, so Medicare paid for the tetanus shot/admin but then took back the payment for G0008 only, saying the denial is due to incorrect/missing modifier.

I’ve read that we should have used -59 on the 90471, but then I also saw a post saying that they did that and was still denied. Then I came across a suggestion to append a G code.

Has anybody come across the same situation? Any suggestions on exactly what modifiers and to which codes it should be attached?

ETA: I did find that Medicare requires -AT for the tetanus admin, but then they paid for it without that.

Thank you!