CMS Instructs Contractors to Hold Fluzone Claims

The Centers for Medicare & Medicaid Services (CMS) is changing the payment status indicator for CPT® code 90662 Influenza virus vaccine, split virus, preservative free, enhanced immunogenicity via increased antigen content, for intramuscular use from “E” (not paid under the Outpatient Prospective Payment System (OPPS)) to “L” (not paid under OPPS; paid at reasonable cost; not subject to deductible or co-insurance) in the October 2010 Integrated Outpatient Code Editor (IOCE).

CMS is instructing contractors to hold claims submitted on or after Dec. 23, 2009 and before Oct. 1, and to release them for processing after the implementation of the October 2010 IOCE.

Providers don’t need to take action on claims containing code 90662 that are held because the IOCE will be updated. If a provider is aware of claims that were processed in error before the claims hold began, the provider should request its contractor to adjust the claims.


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