Prepare for the H1N1 Vaccine Rush

The Influenza A (H1N1) vaccine is expected to ship mid-October. Will your billing staff be ready for the influx of claims once your physicians’ office begins administering the vaccine?

Medicare Part B will pay for the administration of the H1N1 (swine flu) vaccine.

For each administration of the H1N1 vaccine, report one unit of HCPCS Level II code G9141 Influenza A (H1N1) immunization administration (includes the physician counseling the patient/family), with ICD-9-CM diagnosis code V04.81 influenza and, depending on the provider type, revenue code 771. Payment for G9141 is set at the same rate as G0008 Administration for influenza virus vaccine.

The H1N1 vaccine will be made available at no cost to providers; therefore, Medicare will not pay for the vaccine. Do not place HCPCS Level II code G9142 Influenza A (H1N1) vaccine, any route of administration on the claim.

Nor should you report an evaluation and management (E/M) code when the only purpose of the office visit is to administer the H1N1 vaccine.

Remember: Medicare will cover both seasonal flu and H1N1 vaccines providing they are medically necessary.

Read MLN Matters article SE0920, entitled “Billing for the Administration of the Influenza A (H1N1) Virus Vaccine” for complete details.

For further guidance, it may not be too late to register your physician for “Physicians Prepare for the 2009 H1N1 Flu,” a 1-hour Webinar, scheduled for Sept. 22, 7 p.m. CST.

Hosted by the American Medical Association (AMA) in cooperation with the Centers for Disease Control and Prevention (CDC) and the Department of Health and Human Services (HHS), participants will learn current clinical guidelines for flu managment and epidemiology of the 2009 H1N1 flu virus.

This Webinar is free, but space is limited to 1,000 individuals. Register today!


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2 Responses to “Prepare for the H1N1 Vaccine Rush”

  1. vijaymk says:

    im vijaymk medical record officer, RAJIV GANDHI INSTITUTE OF CHEST DISEASES, BANGALORE, INDIA,
    pl let me knwo icd 10 code for Influenza A(H1N1) suspected, isolated, positive


  2. D. Lopez says:

    Happy New Year!!

    Referencing Edgeblast, Industry News, September 14th, 2009. Is this still the current coding guideline for H1N1? Is 90663 being used at all? And, was there ever a CPT code 90470. If so, what was the narrative text, and when was it deleted.

    Appreciate your guidance,

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