Flu Vaccines 2008
Posted on July 25, 2010 | No Comments
Nat Wynn asked:
It’s time to start thinking about flu shots again. Today’s post is just a short primer on the appropriate CPT and ICD-9 codes utilized in those immunizations.
For intranasal mist the code is 90660 with an administration code of 90473. Medicare of Georgia allows $22.031 in the drugs and biologicals but does not approve any payment for the vaccine under the physician fee schedule and has no approved amount for the administration code. California BCBS does not approve either, but the federal FEP does approve the vaccine but will not pay for the administration. In 2004 California BCBS did cover the service but said it was as a result of there being a shortage of available IM vaccine.
Intramuscular vaccines are listed as four codes:
o 90655 Influenza virus vaccine, preservative free, for ages 6-35 months IM
o 90656 Influenza virus vaccine, preservative free, for ages 3 years and above IM
o 90657 Influenza virus vaccine, for ages 6-35 months IM
o 90658 Influenza virus vaccine, for ages 3 years and above IM
Administration codes are 90741 for CPT and G0008 for Medicare. As of this posting, Medicare for Georgia has posted approved payment amounts in their schedule of $13.218 for 90658 under drugs and biologicals (not in the physician fee schedule as of this posting) but no posting for G0008. Although they did post the following in their newsletter Part B Medicare News for October 20, 2008
October Flu Shot Reminder
Flu Season Is Upon Us! Begin now to take advantage of each office visit as an opportunity to encourage your patients to get a flu shot. It’s still their best defense against combating the flu this season. (Medicare provides coverage of the flu vaccine without any out-of-pocket costs to the Medicare patient. No deductible or copayment/coinsurance applies.) And don’t forget, health care personnel can spread the highly contagious flu virus to patients. Protect Yourself. Don’t Get the Flu. Don’t Give the Flu. Get Your Flu Shot.
Remember – Influenza vaccine plus its administration are covered Part B benefits. Note that influenza vaccine is NOT a Part D covered drug.
The ICD-9 codes for these procedures are:
o V04.81
o V06.6 – Purpose of visit was to receive both PPV and Flu vaccines (effective 10/1/06)
Hope this helps with the flu vaccine for the current year. Your medical billing staff should have all the tools necessary to get you paid.
Website content
It’s time to start thinking about flu shots again. Today’s post is just a short primer on the appropriate CPT and ICD-9 codes utilized in those immunizations.
For intranasal mist the code is 90660 with an administration code of 90473. Medicare of Georgia allows $22.031 in the drugs and biologicals but does not approve any payment for the vaccine under the physician fee schedule and has no approved amount for the administration code. California BCBS does not approve either, but the federal FEP does approve the vaccine but will not pay for the administration. In 2004 California BCBS did cover the service but said it was as a result of there being a shortage of available IM vaccine.
Intramuscular vaccines are listed as four codes:
o 90655 Influenza virus vaccine, preservative free, for ages 6-35 months IM
o 90656 Influenza virus vaccine, preservative free, for ages 3 years and above IM
o 90657 Influenza virus vaccine, for ages 6-35 months IM
o 90658 Influenza virus vaccine, for ages 3 years and above IM
Administration codes are 90741 for CPT and G0008 for Medicare. As of this posting, Medicare for Georgia has posted approved payment amounts in their schedule of $13.218 for 90658 under drugs and biologicals (not in the physician fee schedule as of this posting) but no posting for G0008. Although they did post the following in their newsletter Part B Medicare News for October 20, 2008
October Flu Shot Reminder
Flu Season Is Upon Us! Begin now to take advantage of each office visit as an opportunity to encourage your patients to get a flu shot. It’s still their best defense against combating the flu this season. (Medicare provides coverage of the flu vaccine without any out-of-pocket costs to the Medicare patient. No deductible or copayment/coinsurance applies.) And don’t forget, health care personnel can spread the highly contagious flu virus to patients. Protect Yourself. Don’t Get the Flu. Don’t Give the Flu. Get Your Flu Shot.
Remember – Influenza vaccine plus its administration are covered Part B benefits. Note that influenza vaccine is NOT a Part D covered drug.
The ICD-9 codes for these procedures are:
o V04.81
o V06.6 – Purpose of visit was to receive both PPV and Flu vaccines (effective 10/1/06)
Hope this helps with the flu vaccine for the current year. Your medical billing staff should have all the tools necessary to get you paid.
Website content