Part B Insider (Multispecialty) Coding Alert

Physician Note:

90654: Quell Confusion About New Flu Shot Code

Plus: If hospice patient recovers, he may not be eligible for hospice.

When it comes to Part B payment, you can't always count on an "effective date" being the same thing as a "coverage date."

Such is the case with 90654 (Influenza virus vaccine, split virus, preservative-free, for intradermal use), which debuted on Jan. 1, 2011, but was too late to make the 2011 CPT® book so it makes its first appearance in the 2012 manual. Even though the code was added "effective January 1, 2011," it didn't become payable by Medicare until May 9, 2011, a new MLN Matters article explains.

In fact, MACs didn't reimburse for 90654 until May 9, 2011, notes article MM7580, which came out on Oct. 28. To read the entire article, visit www.cms.gov/MLNMattersArticles/downloads/MM7580.pdf.

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