Internal Medicine Coding Alert
Try FluMist Code With Private Payers
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Question: How should we report the new FluMist vaccine? Do payers place restrictions on its use? Answer: For some private insurers, you may bill for the new intranasal flu vaccine using a nonintramuscular immunization code, but Medicare probably won't reimburse you.
Idaho Subscriber
The reason is the Food and Drug Administration recently licensed the intranasal flu vaccine FluMist for healthy patients between the ages of 5 and 49, which excludes most Medicare patients and those with diseases such as cancer or AIDS.
Also, most payers consider the vaccine experimental. If your internist plans to offer FluMist, you should report the services using the following codes:
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