Wiki Coding/Billing Flu and Covid together

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kmcneal@cascadehealth.org

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Trying to find out how to code Flu and COVID together this year - last year we billed them separately even if performed on the same day - not on purpose but they were on different consents and didn't stay together so they just got coded and billed separately - this year we created 1 form with both vaccines on it - I'm hoping to be more efficient and code and bill together on same claim - would we code 90686 (flu vac) and 91320 (covid-Pfizer) and then both admin codes 90471 (flu) and 90480 (covid)? Thanks in advance for anyone's thoughts on this.
 
There are specific CPT codes for the vaccine product based on the manufacturer for the most part although some generic codes such as 91320 were created. For the Pfizer specific CPT codes there are 91312 30 mcg/0.3 mL ages 12 & up and 91315 10 mcg/0.2 mL ages 5-11. Additionally, the Pfizer vaccines are preservative free based on the CPT code descriptions but 91320 is not preservative free based on the CPT description for it.

I believe it is important that the correct CPT codes are used for the vaccine products for tracking and reporting purposes so please make sure that you are using the most specific code available based on the dosage, age and formulation. Also, your fee schedules may not be the same for the Pfizer CPT codes vs. the generic 91320, so you want to make certain you are being reimbursed based on the vaccine product that is being administered.
 
Hi Kmcneal and AJBrown
The admin code for CPT 91312 COVID is CPT 0124A NOT CPT 90471. amin code for CPT 91315 is 0154A. I hope this data helps you:)
Lady T
 
TThivierge said:
Hi Kmcneal and AJBrown
The admin code for CPT 91312 COVID is CPT 0124A NOT CPT 90471. amin code for CPT 91315 is 0154A. I hope this data helps you:)
Lady T
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That is incorrect. The old COVID vaccine and administration codes stopped being used in September 2023 when the new codes became effective. There is a single administration code for all COVID vaccines, which is 90480.
 
eutsler said:
That is incorrect. The old COVID vaccine and administration codes stopped being used in September 2023 when the new codes became effective. There is a single administration code for all COVID vaccines, which is 90480.
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Hi Eutsler,
The coder above is getting denials for CPT 90480.Maybe some payers have not set up to receive this COVID CPT yet. At my medical center we are told to use these for Covid vaccines so following directions. Also differ pharmacy companies make differ variety of COVID vaccines this make a rationale on way used/coded
Thanks for info though
Lady T
 
Hello,
When we bill an Flu and Covid shot together which administration code should we use?
90471 / 90480 or 90480 /90472
Thanks
 
karlie2clay said:
Hello,
When we bill an Flu and Covid shot together which administration code should we use?
90471 / 90480 or 90480 /90472
Thanks
Click to expand...
Has there been an answer? We have billed 90480 with 90471, it denied we billed 90480 with 90472 it denied, we billed 90840 with 90474 it denied. Is 90480 just a Medicare code or is it for commercial insurances also, and if so how do we bill a Covid vaccine and other vaccines and or flu vaccines together?
 
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