Pulmonology Coding Alert

Question: Physicians in our pulmonology practice have administered several flu shots this season. One of the doctors mentioned they read that many of the codes have changed for 2022. If that’s accurate, which codes should we use to report flu vaccination administration?

West Virginia Subscriber

Answer: Your provider is correct. On August 27, 2021, the Advisory Committee on Immunization Practices (ACIP) of the Centers for Disease Control and Prevention (CDC) published its updated recommendations for, and continued guidance on, flu vaccinations. The good news is that not much has changed regarding coding flu vaccines or administration, but the ACIP did issue several changes for the 2021-22 flu season.

The ACIP report stated that influenza vaccines for the season are expected to be quadivalent, so you can retire your trivalent flu vaccine codes for now. You should note that quadrivalent CPT^® codes 90630 (Influenza virus vaccine, quadrivalent (IIV4), split virus, preservative free, for intradermal use) and 90688 (…, 0.5 mL dosage, for intramuscular use) won’t be used during this flu season. Additionally, the CDC also updated the influenza A(H1N1) pdm09 and influenza A(H3N2) components to change the composition of the available quadrivalent vaccines.

Children 2 years old and up are now eligible to receive 90674 (Influenza virus vaccine, quadrivalent (ccIIV4), derived from cell cultures, subunit, preservative and antibiotic free, 0.5 mL dosage, for intramuscular use) and 90756 (…, antibiotic free, 0.5 mL dosage, for intramuscular use). This change occurred in March 2021; before that, the vaccine was only approved for children 4 through 18 years of age.

For the 2021-22 flu season, the ACIP approves vaccinating pregnant women in their third trimester. Children 6 months through 2 years requiring two doses four weeks apart should receive their first dose as soon as possible.

With the push for COVID-19 vaccination across the country at the same time as the flu season’s arrival, the ACIP doesn’t see a reason why your provider cannot co-administer a flu vaccine with a COVID-19 vaccine at the same visit. However, the committee recommends your provider consult COVID-19 vaccine recommendations and guidance for up-to-date information.