Pediatric Coding Alert

Question: Like most peds offices at this time of year, we're ramping up our vaccinations for the upcoming flu season. With the new CPT^® changes just around the corner, are there any new codes we should be aware of?

New York Subscriber

Answer: Just in time for the 2017-2018 influenza season, CPT^® has introduced two new flu vaccination codes: 90682 (Influenza virus vaccine, quadrivalent (RIV4), derived from recombinant DNA, hemagglutinin (HA) protein only, preservative and antibiotic free, for intramuscular use) and 90756 (Influenza virus vaccine, quadrivalent (ccIIV4), derived from cell cultures, subunit, antibiotic free, 0.5 mL dosage, for intramuscular use). The addition of these codes continues the revisions started last year that focus CPT^® descriptors on dosage while discontinuing age specificity.

While both codes will become effective Jan. 1, 2018, CPT^® actually released 90756 on July 1, 2017, and the American Academy of Pediatrics (AAP) has noted that some payers are already accepting the vaccine, which is known by its trade name Flucelvax. But if your payer is not recognizing the code, you can use 90749 (Unlisted vaccine/toxoid) or HCPCS code Q2039 (Influenza virus vaccine, not otherwise specified) in its place if you are vaccinating Medicaid patients.