Wiki Flu Vaccine

[csrigney26@outlook]

The urology/nephrology clinic I work at has been offering flu vaccine. I am getting flu vaccine 90661 denied by Sentara Medicaid of Virginia stating it is the incorrect CPT code. I was wondering if anyone else is having the same issue. The NDC number is correct and Sentara will only tell me that they don't acknowledge that code for the flu vaccine. Sentara is the only carrier that has denied it.

 

[Pam Warren]

Look in your CPT book. There are multiple codes used to report influenza vaccine (90653-90695). Make sure the NDC you are reporting is the same as the flu vaccine description. There are codes for trivalent and quadrivalent, live/derived from cell cultures, and IM or nasal administration. Some are antibiotic free, and some are for particular influenza strains.
Did the state supply you with vaccines? If so, you may have to report according to their guidance.