Wiki Influenza quadrivalent

[cmalone9999]

The new influenza quadrivalent vaccines are coming to offices soon but the new CPT codes will be published in 2014. Will insurances pay? I've looked up some reimbursement rates on insurance websites and they don't have it priced yet. Anybody have more info on this subject with reimbursement for 90685, 90686, 90687, 90688?

We want to start administering them in August 2013.

 

[lburke31]

cpt

we got 90672 for the new vaccine. lburke

 

[lcathey@smsc.org]

90686

We are in Texas and just printed a banner from TMHP showing 90686 payable effective 09/05/13 as follows. Here is a link for the drug: http://www.fda.gov/downloads/BiologicsBloodVaccines/Vaccines/ApprovedProducts/UCM220624.pdf

TOS Age Range Medicaid Fee
1 3-18 Available through TVFC
1 19-999 $17.08
S 3-18 Available through TVFC
S 19-20 $17.08

 

[Lynda Wetter]

View attachment vaccine-codes.pdf

I believe it was a late addition to CPT. I tried to attach something form the AMA not sure it will attach correctly.

 

[MChappell159]

90686

We are already billing in Ohio using the 90686 and our system Athena does not even recognize the code if anyone can provide any info on for sure when this code will be payable please respond with a link.

Thank you
Michelle

 

[arrana]

We just received a state supply of this product. Our EMR doesn't have the new codes, nor does the CPT book. How are we supposed to get this product on claims? For us, since it's state supplied, I'm not worried about reimbursement, but I want to know that our clearinghouse and payors will accept the code.

Any help appreciated.

Arrana Ashton, CPC
Outer Cape Health Services
Wellfleet, MA 02667

 

[trugriff]

We've been billing Quadrivalent Flumist (CPT 90672) for the last month and have been getting good reimbursement without any trouble. Only problem is some small insurance plans are not covering it. Just starting to bill out Quad Flu Vaccine CPT 90685/6-35 months and 90686/>3 years old and not having any problems with it passing through clearinghouses.

If you're having any reimbursement problems contact your Insurance provider reps, they're really helpful

 

[bvanlaan@hotmail.com]

Quadrivalent was a nightmare this year specifically with BCBS. 90686 was recognized but its a single dose vial. 90688 I have had to fight with all flu season because a lot of the insurance companies are reading it as experimental. I have had to call on easily hundreds of them before BCBS started recognizing the code. I am still arguing over some.

 

[tintin]

90688 - Flu vacc

Hello,
Anyone has payment from Medical in California? They approved with no price & required the invoice attached with claim...I still have denial as the invoice info is insufficient????
Please help how to bill Medical for this procedure....
Thanks
Helen