Oncology & Hematology Coding Alert

Question: I heard that the code for flu vaccine (90659) has been changed to 90658 in 2003. Is this correct? South Carolina Subscriber Answer: Yes, the influenza codes have changed in 2003. If you are administering the vaccine whole, which is usually the case with adults, 90659 (Influenza virus vaccine, whole virus, for intramuscular or jet injection use) does not apply this year because they are not making a "whole vaccine." When you administer the split virus, 90658 (Influenza virus vaccine, split virus, 3 years and above dosage, for intramuscular or jet injection use) is used for patients age 3 and above, while 90657 (Influenza virus vaccine, split virus, 6-35 months dosage, for intramuscular or jet injection use) is for children younger than age 3. You may also report the vaccine supply with 90660 (Influenza virus vaccine, live, for intranasal use). For all patients, you should report the administration of the injection and also identify the vaccine product using code range 90476-90749.

For Medicare and carriers that follow Medicare guidelines, you should use G0008 (Administration of influenza virus vaccine when no physician fee schedule service on the same day) or G0009 (Administration of pneumococcal vaccine when no physician fee schedule service on the same day). Also, G0008 and G0009 may be reported in addition to the immunization code (e.g., 90657, Influenza virus vaccine, split virus, 6-35 months dosage, for intramuscular or jet injection use) and the E/M service despite the code's descriptor stating, "when no physician fee schedule service on the same day."