ED Coding and Reimbursement Alert

Double check your code assignments to make sure you comply with payer instructions. Flu season can be a busy time in the emergency department, especially if an epidemic hits the area. Although ideally not the place for preventive care, your ED physician may provide flu shots for certain patient populations that seek treatment there. To better recoup deserved reimbursement for these services, take note of the differences between CPT® and Medicare for flu vaccine codes. CPT® has several codes describing administration of influenza virus vaccine depending on the formula of the vaccine, method of administration, and age of the patient. For example, the variables of "split virus" and "preservative free" and "pandemic formula H1N1" are used to differentiate codes describing specific vaccinations. Tip: Watch for intramuscular as opposed to intranasal delivery in the notes to select the code that accurately describes the service provided. 2011 CPT Codes for Influenza Vaccine [...]