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Pediatric Coding Alert

Watch Out:

CPT Contains 3 Fluzone Vaccine Codes

Published on Sun Nov 14, 2004

Check your influenza-inoculation billing skills with this quiz
 
Apply your reading knowledge and see if you can score 100 on this flu immunization claim.
 
Don't let the fact that you could accurately file a single influenza vaccine with 90655, 90657 or 90658 throw you. Follow steps one and two that the article "What Flu-Shot Component Is Costing You Dollars?" describes to determine how you should report two Fluzone products.
 
Examples:
 A nurse gives a 1-year-old child a shot containing:
  

  • thimerosal-free regular Fluzone
      
  • regular Fluzone.

    Hint: Thimerosal-free means that the product is preservative-free.
     
    Answer: You should report a regular Fluzone shot with 90657, and a preservative-free Fluzone shot with 90655.
     
    Step 1: Because the child is 1 year old, you can narrow your code selection to 90655 or 90657.
     
    Step 2: Look at the product. For a regular, not preservative-free product, you should report 90657. When you administer Fluzone Preservative-Free, Pediatric Dose, Influenza Virus Vaccine, assign 90655.
     
    Tip: You will always assign 90655 for Fluzone Preservative-Free because you can use the product only for children under age 3.
     
    When you give regular Fluzone to a patient who is 3 years of age and older, report 90658.

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