Pulmonology Coding Alert

Question: I heard H1N1 and flu vaccines are combined this year. We were using 90663 for H1N1 and 90658 for the regular flu. Is there a code for the combined vaccine?

Answer: For 2011 there are several new combination codes for the flu/H1N1 vaccine:

• 90664 -- Influenza virus vaccine, pandemic formulation, live, for intranasal use
• 90666 -- Influenza virus vaccine, pandemic formulation, split virus, preservative free, for intramuscular use
• 90667 -- Influenza virus vaccine, pandemic formulation, split virus, adjuvanted, for intramuscular use
• 90668 -- Influenza virus vaccine, pandemic formulation, split virus, for intramuscular use

Careful: Do not use 90663 (Influenza virus vaccine, pandemic formulation, H1N1) as a standalone because standard flu shots now include the H1N1 vaccine. CPT keeps 90663 but you won't report it.

Definition: A split virus vaccine consists of a purified antigenic determinant separated from the disease-causing organism. On the other hand, a live virus vaccine contains an attenuated virus, meaning the virus has been altered, so it produces natural immunity but does not produce the disease.