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Influenza vaccine CPT


Best answers
Hello~ I'm looking for a CPT for influenza virus vaccine CPT. We are using Fluzone by Sanofi Pasteur. Administration is IM and this vaccine does have preservatives in it. I thought that this should be 90658 but I recevied a denial from the carrier saying the NDC does not match. I've checked the NDC several times to make sure that we submitted it correctly. I would appreciate any feedback if I'm coding incorrectly.

I originally posted this in the General forum and someone replied back that the code should be Q2038. My question is - is this code for Medicare only or for commercial carriers also?


Best answers
Q2038 is Medicare's translation of 90658 only.

What we have in Our clinic-
90654 Intrgermal Pres Free
90655 Pres Free IM 6-36mo Age
90656 Pres Free IM 3+yrs
90658 NON Pres Free IM 3+yrs

Q2038 is Medicare only as of Jan 1 2011.

Hope That Helps :)
Best answers
Reply to Flu shot coding. *(payment denial)

2012 FLU vacine is FLUVIRIN by Novartis and has been effective since April 2012. the cpt code is 90654 For Medicare IM Fluvirin use Q2038 and Cpt code 90654. I hope this helps.