Ob-Gyn Coding Alert
Investigate Whether Flu Shot Has Preservatives
Question: What is the correct CPT® code for flu shots for pregnant patients between the two below?
90656 flu preservative free
90658 flu split virus
I have been using 90656, but a webinar I listened to today gave conflicting information.
Answer: You should choose the correct code based on what the product label of the flu shot you are injecting says. You will find information that will tell you if it is preservative free or the split virus.
Tactic: Every flu season, you need to identify with your provider the exact flu vaccine(s) you are giving and then pick the CPT/Q code based on this information.
But for your general information, Thimerosal is a mercury-based preservative that is used in multi-dose vials of some vaccines to prevent the growth of germs, bacteria and fungi that can contaminate them. Since seasonal influenza vaccine is produced in large quantities for annual immunization campaigns, some of the vaccine is produced in multi-dose vials and contains thimerosal to safeguard against possible contamination of the vial once it is opened. All injections from a multi-dose vial will contain a preservative, so you would not report code 90656 (Influenza virus vaccine, trivalent, split virus, preservative free, when administered to individuals 3 years and older, for intramuscular use).
You can access the CDC table of flu vaccines that indicates the ones that include a preservative and those that don’t by dosage (and trade name) at http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6132a3.htm#tab.
The single-dose units (coded as 90656) are made without thimerosal as a preservative, because they are intended to be opened and used only once. Additionally, the live-attenuated version of the vaccine (the nasal spray vaccine) is produced in single-dose units and does not contain thimerosal. So your codes for preservative free single dose flu vaccines for adults will be 90654 (Influenza virus vaccine, split virus, preservative-free, for intradermal use), 90656 (IM), or 90660 (Influenza virus vaccine, trivalent, live, for intranasal use).
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Ob-Gyn Coding Alert
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