Question: How should I code the new Fluarix TIV influenza vaccine for individuals less than 18 years of age? Answers to You Be the Coder and Reader Questions provided by Catherine A. Hudson, RMA, RPT, office manger at Cumberland Pediatrics PC in Marietta, Ga.; Jack Percelay, MD, MPH, FAAP, immediate past-chairperson of the American Academy of Pediatrics Section on Hospital Medicine; and Sherry Wilkerson, RHIT, CCS, CCS-P, coding and compliance manager at Catholic Healthcare Audit Network in Clayton, Mo.
Illinois Subscriber
Answer: Fluarix is a trivalent preservative-free inactivated influenza vaccine (TIV) that prevents type A and B influenza. You shouldn't, however, use this product for young populations. The FDA recently approved the GlaxoSmith-Kline intramuscular injection for adults 18 years of age and older.
Step 1: You should code shot administration as 90471-90472 (Immunization administration [includes percutaneous, intradermal, subcutaneous, or intra-muscular injections] ...). Assign 90471 (... one vaccine [single or combination vaccine/toxoid]) when staff give Fluarix as a single or initial vaccine or 90472 (... each additional vaccine [single or combination vaccine/toxoid [list separately in addition to code for primary procedure]) for an additional vaccine.
Step 2: For the preservative-free adult-only product, use 90656 (Influenza virus vaccine, split virus, preservative free, for use in individuals 3 years and above, for intramuscular use).
Step 3: Link both the immunization administration and the product to ICD-9 code V04.81 (Need for prophylactic vaccination and inoculation against other viral diseases; influenza).