Pulmonology Coding Alert

Question: A 58-year-old established patient reports to the pulmonologist for a flu shot. The pulmonologist's nurse injects the patient with the vaccine (which contained preservatives). How should I report this encounter? Does it depend on the payer?

Delaware Subscriber

Answer: It absolutely depends on the payer. When you choose codes for the vaccine administration, remember that coding depends on whether or not the patient has Medicare insurance.

For private carriers, report the following codes:

• 90471 (Immunization administration [includes percutaneous, intradermal, subcutaneous, or intramuscular injections]; one vaccine [single or combination vaccine/toxoid]) for the flu shot

• 90658 (Influenza virus vaccine, split virus, when administered to individuals 3 years of age and older, for intramuscular use) for the flu vaccine supply.

Medicare coding: When the pulmonologist provides a Medicare patient with flu vaccine, report G0008 (Administration of influenza virus vaccine) for the administration and 90658 for the vaccine.