# New Flu vaccine codes for 2010



## rhs281 (Aug 3, 2010)

Can anyone give me some insight as to the new CPT codes for the 2010 Flu vaccines?  We are getting conflicting information regarding which codes to use for this years' flu vaccine. We are being told that the flu vaccine for this year is suppose to include H1N1 so would we be using the same codes that  we would use for the regular flu codes each year and if so, why are there four new codes approved for use eff 7/1/10? : 90664,90666,90667 & 90668 - the description of these codes state influenza vaccine,pandemic formulation...
Any information you could give me would be greatly appreciated
Robyn Serino, CPC
Pembroke, Massachusetts


----------



## lemmde (Aug 13, 2010)

*90664-90668*

It is my understanding that these new codes are for pandemic strains only.  If they were available for last years H1N1 we would have used them.  This year H1N1 is incluisive with the seasonal flu vaccine but that does not mean the seasonal flu needs to be labled as a pandemic vaccine.  It still is a seasonal vaccine and we should still be using 90655-90660.  We probably will not use 90664-90668 until the next pandemic is identified unless H1N1 is given as a monovalent and not as part of the seasonal vaccine. 
Can anyone verify this???  
Thanks
Dianne
Norfolk VA


----------



## DoDCoder4You (Aug 13, 2010)

The Swine Flu is not included in the "Normal Flu" Not that the Flu is normal. 



H1N1 Swine Flu	
ICD -9 -----V04.81	
E&M -------99499	
VACCINE ---90663	
ADMIN ------90470


----------



## mitchellde (Aug 13, 2010)

why the unlisted E&M?  If the reason for the encounter is a vaccine then there is no E&M charge  
HiNi vaccine is non chargeable as the vaccine is provided free of charge.  Some payers want it listed with either a $0 or $.01 charge.  This may be where the first poster received conflicting info.  The admin code is the 90470 and is an initial code so if you give two vaccines then the second is coded with 90472.


----------



## mamabird52803 (Aug 16, 2010)

▲90663 Influenza virus vaccine, pandemic formulation, H1N1 
&#56256;&#56442;90470 H1N1 immunization administration (intramuscular, intranasal), including counseling when performed


----------



## Lisa Bledsoe (Aug 16, 2010)

We have been using G9142 (zero charge) for the vaccine (H1N1 vaccine, any route of administration) and G9141 (immunization administration; includes the physician counseling the patient/family).   We have not encountered any problems with commercial insurance.


----------



## lemmde (Aug 17, 2010)

*90664-90668*

The new 90664-90668 are for pandemic vaccines.  It is no longer appropriate to bill 90663.

The fact that H1N1 is one of the 3 strains in the 2010-2011 seasonal vaccine does not make it a "pandemic vaccine".  90655-90660 are to be used for seasonal flu vaccines for the 2010-2011 season.


----------



## Lisa Bledsoe (Aug 17, 2010)

*G9141 and G9142*

These are the appropriate codes


----------



## mamabird52803 (Aug 17, 2010)

According to the AMA 90663 was specifically revised to include the H1N1 immunizationand should be used for the vaccine itself. The American Medical Association (AMA) announced the publication of a new code specific to vaccine administration and revised existing code 90663 to include the H1N1 vaccine.
And yes for seasonal Flu 90655-90660 are to be used.
The regular flu is not included with the H1N1 they are separate administrations and have seperate codes

Erica Barden,CPC


----------



## KellyLR (Aug 17, 2010)

*Vaccine info*



rhs281 said:


> Can anyone give me some insight as to the new CPT codes for the 2010 Flu vaccines?  We are getting conflicting information regarding which codes to use for this years' flu vaccine. We are being told that the flu vaccine for this year is suppose to include H1N1 so would we be using the same codes that  we would use for the regular flu codes each year and if so, why are there four new codes approved for use eff 7/1/10? : 90664,90666,90667 & 90668 - the description of these codes state influenza vaccine,pandemic formulation...
> Any information you could give me would be greatly appreciated
> Robyn Serino, CPC
> Pembroke, Massachusetts



I thought I still had the updated codes in my email from the CDC but I don't  I've already transferred them to my CPT and I'm not close to my books right now.  Here a link you can try for the CDC:
www.cdc.gov/search.do?action=search&subset=nip&queryText=coding+for+h1n1


----------



## Skenyon (Aug 25, 2010)

*Does New Vaccine have New Codes*

I was told by the vendor that H1N1 is inclusive of the seasonal flu shot, so what code should we use?  I'm thinking 90655-90660.


----------



## mitchellde (Aug 25, 2010)

It is not inclusive it has its own code, 
90663 Influenza virus vaccine, pandemic formulation, H1N1 to report the H1N1 vaccine product, 
and newly created code 
90470 H1N1 immunization administration (intramuscular, intranasal), including counseling when performed to report H1N1 immunization administration and counseling.
For Medicare, report 
G9142 Influenza A (H1N1) vaccine, any route of administration to describe the H1N1 vaccine itself and 
one unit of 
G9141 Influenza A (H1N1) immunization administration (includes the physician counseling the patient/family) to describe each administration of the H1N1 vaccine. Beneficiary copayment and deductible do not apply to HCPCS code G9141.
The G codes are for Medicare and any other payer that wants as they are carrier discretion.
Also from CMS:
Neither of these revisions are in the 2010 CPT manual but were
active codes as of September 28, 2009.
Note: 90470 is a code which was deleted in 1999. It was revitalized
and is now a new and different code. Some of the reimbursement
issues may be due to its deleted status.
To report the administration of 2009 H1N1 influenza type A
monovalent vaccine, providers should report CPT code 90663
(Influenza virus vaccine, pandemic formulation, H1N1) in
conjunction with the immunization administration code 90470 (H1N1
immunization administration (intramuscular, intranasal), including
counseling when performed). Providers will be paid for 2009 H1N1
vaccine administration. Since the 2009 H1N1 vaccine will be
provided free of charge, no payment will be issued for 90663.
CMS guidance for reporting the charge of the 2009 H1N1 vaccine
product on the claim form is that zero dollars should be listed
following code 90663. Other payer plans may vary. For payer
requirements, see the payer-specific web sites for further billing
information.
In the event that a seasonal flu vaccination is administered in addition
to the H1N1 vaccination at the same visit, it is necessary that code
90470 should be reported for the initial administration service for the
H1N1 vaccine product, and either code 90466, 90468, 90472, or
90474 for the additional administration service. The H1N1 vaccine
administration code should not be reported in addition to the initial
service vaccine administration codes 90465, 90467, 90471, and
90473 because these changes were made after the publication of the
2010 CPT manual and therefore the add on vaccine administration
codes have not been updated to include 90470. To reiterate, these
changes were made after the publication of the 2010 CPT manual.
Therefore, the instructional notes following the add-on vaccine
administration codes have not been updated to include 90470 in the
list of primary procedures. However, appropriate reporting of
multiple vaccine administrations is to report one initial administration
code and the appropriate add-on administration code(s) 90466,
90468, 90472, or 90474 for the additional administration(s). Be sure
to check with your payer or visit the AMA H1N1 Web site for a
listing of payer billing requirements


----------



## cmcgarry (Aug 27, 2010)

The original question was whether or not this year's seasonal influenza vaccine will protect against H1N1, and if so were the codes changing.  I do have an e-mail from CMS entitled "August is National Immunizatio Awareness Month" which states: Seasonal Influenza Immunization

Medicare provides payment for the seasonal influenza vaccine and its administration for all people with Medicare, once per influenza season, in the fall or winter. Medicare may cover additional influenza vaccinations, if medically necessary. (Note: According to the Centers for Disease Control and Prevention, the 2010 – 2011 influenza vaccine will protect against the 2009 H1N1, and two other influenza viruses http://www.cdc.gov/flu/about/disease/.)

They go on to say that their Adult Immunizations Web Page (http://www.cms.gov/AdultImmunizations/) has more information, and that the Q & A Guide will be updated and posted to the site sometime in October 2010.  

That said, if the seasonal influenza vaccine we receive this year includes the H1N1, there will be no reason to code it separately, as we won't be giving separate immunizations.  Also, according to practice at our organization, last year we did not give the seasonal and H1N1 on the same date.  (Of course, part of that may have been availability and who was and wasn't eligible to get the H1N1 when we were still short of it!)


----------



## Cynthia_R (Sep 24, 2010)

I am a little confused please correct me. I read that code 90656 should be used for the influenza immunization this year 2010 because H1N1 was included in the vaccine. Is this correct...I have been currently using 90658...Please advise. Thanks!


----------



## cmcgarry (Sep 24, 2010)

Cynthia_R said:


> I am a little confused please correct me. I read that code 90656 should be used for the influenza immunization this year 2010 because H1N1 was included in the vaccine. Is this correct...I have been currently using 90658...Please advise. Thanks!



H1N1 is included as part of the seasonal influenza vaccine this year.  Use code 90656 for the preservative free, and 90658 if not the preservative free.  Check to see which kind you received from the manufacturer.  We are multiple clinics, and some have received one kind, and some the other.

Hope this helps,


----------



## jenniferls (Nov 8, 2010)

*Influenza 2010 new vaccine code*

Hey there ! I found this on the NC BCBS web site http://www.bcbsnc.com/content/providers/important-news/oct8-2010.htm
It says to use 90658 for someone who is over 3 yrs of age , this is for the preservative ,you'll have to look up the preservative free I don't have my books at home.   *Not 90668.*  This is the best thing I've found so far, our office has billed 90668 and no one is paying it so who knows . It's been really hard to get anyone to tell you what your suppose to use ! Hope this helps !


----------



## jenniferls (Nov 9, 2010)

If you go to the link i posted bcbs does say in black and white to use 90658 for the (trivalent) which is 2other types of influenza and h1n1 this years vaccine these other codes 90668 are for a pandemic (outbreak)


----------



## grossap (Nov 23, 2010)

Well...that cleared that up!


----------



## iovine (Dec 15, 2010)

we are new to giving flu shots so you are saying to use
icd 9 code: V04.81
E&M
vaccine 90655
admin 90465


----------

