Oncology & Hematology Coding Alert

Trivalent and quadrivalent options are both available for 2013.

Flu vaccines are constantly evolving, and that means coding options are, too. If your practice provides vaccines, be on the lookout for these code changes.

Prepare for 'Official' and Revised Vaccine Codes

Several code changes will impact your reporting in 2013, affecting your influenza vaccine administration.

Additions: Two new influenza immunization product codes were released in July 2012, and they will become effective Jan. 1, 2013. Your new code choices will include 90653 (Influenza virus vaccine, inactivated, subunit, adjuvanated, for intramuscular use) and 90672 (Influenza virus vaccine, quadrivalent, live, for intranasal use). Code 90672 is noted as a "resequenced code," meaning the AMA placed the code out of numerical order in the CPT® text so it would be with similarly defined codes. You'll find 90672 under 90660, which will be revised as noted below.

Revisions: Flu vaccine codes 90655-90660 will be updated in 2013 with the addition of the term "trivalent," meaning that the vaccine protects against three influenza viruses and that all three components are built into one vaccination:

• 90655, Influenza virus vaccine, trivalent, split virus, preservative free, when administered to children 6-35 months of age, for intramuscular use
• 90656, Influenza virus vaccine, trivalent, split virus, preservative free, when administered to individuals 3 years and older, for intramuscular use
• 90657, Influenza virus vaccine, trivalent, split virus, when administered to children 6-35 months of age, for intramuscular use
• 90658, Influenza virus vaccine, trivalent, split virus, when administered to individuals 3 years of age and older, for intramuscular use
• 90660, Influenza virus vaccine, trivalent, live, for intranasal use.

Note: You Can Use These Codes Before 2014 Printing

The CPT® Editorial panel announced four more influenza vaccine codes that will go into effect in 2013, but you won't find them in your CPT® text until 2014 (www.ama-assn.org/resources/doc/cpt/vaccine-codes.pdf). The new codes include:

• 90685, Influenza virus vaccine, quadrivalent, split virus, preservative free, when administered to children 6-35 months of age, for intramuscular use
• 90686, Influenza virus vaccine, quadrivalent, split virus, preservative free, when administered to individuals 3 years of age and older, for intramuscular use
• 90687, Influenza virus vaccine, quadrivalent, split virus, when administered to children 6-35 months of age, for intramuscular use
• 90688, Influenza virus vaccine, quadrivalent, split virus, when administered to individuals 3 years of age and older, for intramuscular use.

"These codes are essentially the quadrivalent version of codes 90655-90658," says Kent J. Moore, manager of healthcare delivery and finance systems for the American Academy of Family Practice (AAFP) in Leawood, Kan. "That's why the word 'trivalent' was added to each descriptor."

Caveat: All four codes carry the lightning bolt symbol in AMA materials indicating that FDA approval is pending. So check for FDA approval of each vaccine represented by the code before using the associated code. "The codes probably shouldn't be used until FDA approval or on January 1, 2013, whichever comes later," Moore advises.