Question: Answer: CPT offers 90656 (Influenza virus vaccine, split virus, preservative free, when administered to individuals 3 years and older, for intramuscular use) or 90658 (Influenza virus vaccine, split virus, when administered to individuals 3 years of age and older, for intramuscular use) for flu vaccine supply for adult patients. How to choose: If the packaging does not help, contact the manufacturer and ask if the vaccine contains thimerosal. Then, make sure other coders and physicians know which vaccines contain preservatives and which do not. Most of the single-dose pre-filled syringes are preservative-free, whereas the multi-dose vials are not. Medicare: Q2035 -- Influenza virus vaccine, split virus, when administered to individuals 3 years of age and older, for intramuscular use (Afluria) Q2036 -- Influenza virus vaccine, split virus, when administered to individuals 3 years of age and older, for intramuscular use (Flulaval) Q2037 -- Influenza virus vaccine, split virus, when administered to individuals 3 years of age and older, for intramuscular use (Fluvirin) Q2038 -- Influenza virus vaccine, split virus, when administered to individuals 3 years of age and older, for intramuscular use (Fluzone) Q2039 -- Influenza virus vaccine, split virus, when administered to individuals 3 years of age and older, for intramuscular use (Not Otherwise Specified). In a confusing twist, the Q codes are effective for services on or after Oct. 1, 2010, but the Medicare claims processing system won't recognize the codes until Jan. 1, 2011. Medicare instructs that you may either bill Oct. 1, 2010, to Dec. 31, 2010, services using 90658, or you may hold those claims until Jan. 1 and bill using the appropriate Q code. Resources: Admin: For Medicare patients, you should instead report G0008 (Administration of influenza virus vaccine) for the flu vaccine administration. See also: