Pulmonology Coding Alert

Question: How should I report flu vaccine supply?

Hawaii Subscriber

Answer: You'd have to choose between 90656 (Influenza virus vaccine, split virus, preservative free, when administered to individuals 3 years and older, for intramuscular use) or 90658 (Influenza virus vaccine, split virus, when administered to individuals 3 years of age and older, for intramuscular use).

Difference: You'll use 90656 for vaccines without preservatives, and 90658 when the vaccines contain preservatives. One way to tell if the vaccine has preservative is to check its packaging. The insert in the package indicates whether it has thimerosal preservative.

Another option: If the packaging does not help, contact the manufacturer and ask if the vaccine contains thimerosal. Then, make sure other coders and physicians know which vaccines contain preservatives and which do not. Most of the single-dose pre-filled syringes are preservative-free, whereas the multi-dose vials are not.