Primary Care Coding Alert

Question: It seems like every year the AMA adds yet another CPT® code for a flu vaccine. Is this going to be true for 2019?

New York Subscriber

Answer: Yes. This year, you’ll need to add 90689 (Influenza virus vaccine, quadrivalent (IIV4), inactivated, adjuvanted, preservative free, 0.25 mL dosage, for intramuscular use) to your list of flu vaccine codes.

Billing alert: If you’re billing Medicare for the service, you should note the billing dates for the procedure. “The new influenza virus vaccine code 90689 is not retroactive to August 1, 2018. No claims should be accepted for influenza virus vaccine code 90689 between the DOS August 1, 2018, and December 31, 2018. If claims are received in January 2019 with code 90689 for DOS between August 1, 2018, and December 31, 2018, [Medicare administrative contractors] will follow their normal course of action for codes billed prior to their effective date,” according to the Centers for Medicare and Medicaid in their Quarterly Influenza Virus Vaccine Code Update - January 2019 published on September 5, 2018 (www.cms.gov/Outreach-and-Education/Medicare-Learning-Network-MLN/MLNMattersArticles/downloads/MM10871.pdf).