Pediatric Coding Alert

Question: How should I code the new Fluarix TIV influenza vaccine for individuals less than 18 years of age?


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). 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.