Otolaryngology Coding Alert

Question: Some patients are requesting the H1N1 flu vaccine this fall. What product code would we use? New York Subscriber Answer: It depends on the patient's insurer. The AMA recently confirmed the CPT code to use, but Medicare released its own G codes for the swine flu's vaccine and administration. Here's how to code using both guidelines. Private payers: You would report the H1N1 flu product with the general pandemic vaccine code 90663 (Influenza virus vaccine, pandemic formulation), according to an AMA CPT Category 1 Vaccine Codes clarification. "The appropriate immunization administration code (90465-90474) may be reported in conjunction with 90663 for the administration of the vaccine, depending on the route of administration and the age of the patient," states the update (www.amaassn.org/ama1/pub/upload/mm/362/vaccine-codes.pdf). Beware: The Federal Drug Administration has not yet approved the swine flu vaccine, which is not included in the traditional influenza vaccines. Therefore, 90663 is not listed [...]