Primary Care Coding Alert

Tip: Pay attention to codes with locally-controlled pricing. CMS released its annual update to influenza vaccine payments in early October, with implementation backtracking to August 1, 2012 for any patients visiting your office. Here's your quick look at the latest pricing based on the MLN Matters article "Influenza Vaccine Payment Allowances: Annual Update for 2012-2013 Season." Now it's easy to ensure your practice files accurate claims this flu season. Update Your Medicare Allowances CMS provides payment allowances for several CPT® and HCPCS codes for seasonal influenza virus vaccines, when payment is based on 95 percent of the AWP (average wholesale price). The exception is when payment is based on reasonable cost when providers furnish the vaccine in a hospital outpatient department, rural health clinic, or federally qualified health center. Double check your Medicare Part B payment allowances for these codes, effective for dates of service on or after August 1, [...]