# Preservative Free Flu Vaccine



## dballard2004 (Aug 18, 2011)

Medicare is requiring providers to report code Q2038 for the Fluzone influenza vaccine in place of CPT code 90658.  

Now for a question....the description of code 90658 is for the influenza vaccine, *split virus*  The terminology says nothing about preservative free.  The problem is that some Fluzone vaccine such as those who come in single dose units are preservative free.  

So the question is, if the preservative free version is given, do you report Q2038 or code 90656?  The description of Q2038 is for the Fluzone vaccine.

Hope this question makes sense. 

All insight appreciated.  Thanks.


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## btadlock1 (Aug 18, 2011)

dballard2004 said:


> Medicare is requiring providers to report code Q2038 for the Fluzone influenza vaccine in place of CPT code 90658.
> 
> Now for a question....the description of code 90658 is for the influenza vaccine, *split virus*  The terminology says nothing about preservative free.  The problem is that some Fluzone vaccine such as those who come in single dose units are preservative free.
> 
> ...



I think I'm confused about what your question is...So the Fluzone is preservative free, and that's what you're giving them, right? 

I'd go with the Q2038, because that's what Medicare told you to bill (and because it sounds like that's what you're actually giving them, anyways). CMS makes their own rules, as it is, so I imagine that it's probably the only code they'll accept. I think they probably made the distinction on one CPT and not the other, because of the way the CPT description reads. Just call your MAC!


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## dballard2004 (Aug 18, 2011)

Thanks so much for the reply!

I apologize if my question was confusing.  To my understanding, some (but not all) of the Fluzone vaccine is preservative free.  I understand if you give the non-preservative free version, you would report Q2038 per Medicare's instructions, but if you give the preservative-free version, do you still report the Q code or would you report code 90656 since this represents the preservative free vaccine?


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## btadlock1 (Aug 18, 2011)

dballard2004 said:


> Thanks so much for the reply!
> 
> I apologize if my question was confusing.  To my understanding, some (but not all) of the Fluzone vaccine is preservative free.  I understand if you give the non-preservative free version, you would report Q2038 per Medicare's instructions, but if you give the preservative-free version, do you still report the Q code or would you report code 90656 since this represents the preservative free vaccine?



I think your answer may be here: http://www.cms.gov/newmedia/02_preventive.asp


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## btadlock1 (Aug 18, 2011)

*Sorry - forgot to mention...*

The info you need is about halfway down the page...


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## dballard2004 (Aug 18, 2011)

Thanks so much!  This is a big help!


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## denarh40 (Oct 7, 2011)

*preservative free fluzone*

What did you determine?  If preservative free fluzone is given do you code it 90656 or Q2038?

Thanks
Dena Brandt CPC


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## dballard2004 (Oct 7, 2011)

I instructed my sites that if you are given regular Fluzone to a Medicare patient, use Q2038.  If you are giving the prservative free version, use 90656.


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## denarh40 (Oct 7, 2011)

*Fluvirin*

Thank you!  I now have another question.  We have Fluvirin with trace amounts of thimerosal.  FDA labels it as preservative free I was told by the Novartis rep. I would then code that as 90656 for a Medicare patient as well instead of Q2037 right?  I appreciate any feedback that can be offered.

Thank you!
Dena Brandt CPC


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