Practice Management Alert

Modify Your Flu, PPV Coding After Oct. 1

Effective Oct. 1, you-ll be able to use diagnosis code V06.6 (Streptococcus pneumoniae [pneumococcus] and influenza) on claims you submit when a patient visits your office for both the pneumococcal pneumonia and influenza vaccines.

Your Medicare carriers now have to accept 90660 (Influenza virus vaccine, live, for intranasal use) for the administration of the intranasal flu vaccine, commonly called Flumist, as well.

How it works: When a patient receives both influenza virus and PPV vaccines and you bill for their administration, report V06.6 on your claim. This instruction allows you to report V06.6 in place of both V03.82 (Streptococcus pneumoniae [pneumococcus]) and V04.81 (Influenza) if the patient came in to receive both vaccines.

Unchanging guidance: Continue reporting V03.82 on claims that contain only PPV vaccine and its administration. Also, you should continue as you have been by reporting V04.81 on claims that contain only the flu vaccine and its administration.

Remember: Make sure you code the administration of the vaccine on your claim. Use G0008 (Administration of influenza virus vaccine when no physician fee schedule service on the same day) to bill Medicare for a flu shot administration.

For the administration of the pneumonia vaccine to a Medicare beneficiary, use G0009 (Administration of pneumococcal vaccine when no physician fee schedule service on the same day).

Bonus: -Medicare is also allowing for payment of intranasal influenza (90660),- says Cheryl Scott, CPC, CPC-H, CCS, CCS-P, coding consultant with Health Texas in Dallas. -The administration of the intranasal flu vaccine should still be reported with G0008.-

What it means to you: The instructions from CMS are pretty straightforward, and as long as you update your billing process and superbill so you-re using V06.6, you should have no trouble getting paid on your flu shot and pneumonia vaccine services.
 
-If you follow the guidelines, you shouldn't have any issues,- says Lisa Center, CPC, coder with Mount Carmel Regional Medical Center in Pittsburg, Kan.