Flu Shots

peltdl

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Someone at our clinic has been told that children between the ages of 3 and 9 years old that have never had a flu shot before should receive an initial flu shot (full dose) and then return in 30 days for another flu shot (full dose). Does anyone have any information on this process? And, how do you get paid for the second flu shot being given? I appreciate any help....
 

csehlmeyer

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NH Seacoast
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Peds Flu vaccination

I work in a Family Practice and it is my understanding that Pediatric Flu vaccines are a two dose immunization regardless of previous flu vaccinations. Children under 3 are a v04.81 diagnosis with a 90657, over 3 is 90658. State immunization get the SL modifier with the CPT code. The second vaccination gets the same coding, no difference. I'm not sure if this is what you were looking for but this is my first time I've sent in a responce.:rolleyes:
 

scorrado

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Bridgewater, VA
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I do not code flu shots for children but I do have kids who have had flu shots. My almost 3 year old had to have 2 shots when she was almost one, but last year and this year she only had to have one. The pediatrician said that they only get the two shots when they are getting it for the first time. Hope this helps!
 

peltdl

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We billed for both shots and are receiving denials from the insurance companies. Some state that it is a duplicate service and others are denying as "Maximum benefit paid for this service" Is anyone getting paid for the second flu shot? Not sure how to get paid for the second shot. I think the only was to get them paid would be to write an appeal letter stating that it is recommened that all children get 2 flu shots if they have have never had the shot before. Thanks for everyones help on this.
 
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