# Medicare Flu Vaccine Codes



## jojokat (Sep 23, 2016)

Does anyone know what happened to HCPCS codes Q2036 and Q2038 for the flu vaccines for Medicare this year?  In looking on the CMS website for the seasonal flu vaccine allowed amounts and effective dates (8/1/16 - 7/31/17) and all of the flu vaccine CPT codes are listed, but the Medicare Q-codes for this year are only Q2035, Q2037, and Q2039.  A couple of our clinics have received the Fluzone Q2038 and/or Fluarix already so the question is do our clinics need to utilize the CPT codes for the appropriate vaccine or use the Q2039 for the unspecified vaccine?  We know that the 90662, the high dose flu vaccine, is to be used for all payers including Medicare/Medicare Advantage payers.

Thanks in advance for any assistance.


----------



## danskangel313 (Sep 23, 2016)

If you read here: https://www.cms.gov/Medicare/Medica...crPartBDrugAvgSalesPrice/VaccinesPricing.html it says "Additional information on 2016-2017 Influenza Vaccines pricing is available in MM9758, which is available in the 'Downloads' section below. _Information for some codes is pending FDA approval. Updates to the payment limits and effective dates will be posted to this webpage_."

https://www.cms.gov/Outreach-and-Ed...k-MLN/MLNMattersArticles/Downloads/MM9758.pdf


----------



## DFUGET (Oct 5, 2016)

*flu vaccine question*

I was just informed that one of my provides will be doing flu vaccines. Can you bill an office visit with a 25 modifier along with the vaccine and admin codes? Also would the diagnosis code be Z23  and the POS 11?

Any help is appreciated.


----------



## danskangel313 (Oct 5, 2016)

DFUGET said:


> I was just informed that one of my provides will be doing flu vaccines. Can you bill an office visit with a 25 modifier along with the vaccine and admin codes? Also would the diagnosis code be Z23  and the POS 11?
> 
> Any help is appreciated.



You can only bill an office visit is there is a problem that needs to be addressed. If the patient comes in solely for the vaccine, then no office visit should be charged.


----------



## CodingKing (Oct 5, 2016)

Billing E&m when patient is in for an injection or just a vaccine is a no no. Not even a nurse visit code can be billed.


----------

