H1N1 Vaccine

dballard2004

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If the H1N1 vaccine comes out, does anyone have any idea what CPT code we would use for it? Would we just use the regular CPT code for the influenza vaccine? I know that CPT can create a new code for it, but that won't be released until January, and if the vaccine is released, most places start vaccinating in October. Any ideas?
 
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I am trying to find answers also. From the article I found from the AMA - the general pandemic code 90663 would be used at this time but I am not 100% sure and if that is what we use. Has anyone found a V code to use along with it. Do we use the current V code for the flu? I know that we have ICD-9 codes for patients that have the H1N1 flu, but what if we are giving the vaccine?
 

jenn13088

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H1N1 Vaccine Coding

Has anyone found any information on the H1N1 vaccine code(s)? I have the diagnosis codes but need the procedure codes to check reimbursement. Please help!!

Jenn
 
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The information that I have found so far directs you to use cpt 90663 and dx 488.1 along with the usual administration cpt.

Good luck!
 
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I found information from Novel that states we should use CPT 90663 with V-Code V04.81 the 488 is only for positive tests.
 

LTibbetts

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Go to the website that Lisa Curtis suggested. It has all of the info that you need about all questions (ie, two part injections, administration fee, etc.). It is very informative. Thanks Lisa!!
 

teejae07

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I believe you would only code 90663 if it met the criteria of a pandemic as follows...(also the approval from the FDA for this code is pending)

As part of its preparedness efforts for influenza pandemic, CMS has begun developing certain emergency policies and procedures that may be implemented for the Medicare program in the event of a pandemic or other emergency.
Decision to implement would occur if:
1.
The President declares an emergency or disaster under the National Emergencies Act or the Stafford Act; and
2.
The Secretary of the Department of Health and Human Services declares – under § 319 of the Public Health Service Act – that a public health emergency exists; and
3.
The Secretary elects to waive one or more requirements of Title XVIII of the Social Security Act (Act) pursuant to § 1135 of such Act.


Otherwise, you would use the same codes: 87804,QW and 87804,QW,59 for the second. You can also get info on reimbursement and confirmation on the correct way to code it from the company that supplies your vaccinations. For the record, we are not getting these free of charge. Hope this helps.
 

dcr002

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Wilkesboro, NC
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H1n1

According to MLN SE0920 that came out Sept 03, 2009 they have created a new code that goes into effect on and after Sept. 01, 2009. The code is
G9141---Influenza A (H1N1) immunization administration (includes the physician counseling the patent/family) and G9142---Influenza A (H1N1) vaccine, any route of administration. The article states that they will pay for the G9141 at the same rate established for G0008. Also the H1N1 vaccine will be made available at no cost to providers. So Medicare will not pay for the vaccine and the G9142 does not need to appear on the claim.
 
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