Wiki New 90685-90688 Flu Vaccine Codes

[pbowman5]

I have had a few private payers process these flu vaccine codes as part of office visit procedures instead of falling under well coverage because it is a new code. I also had Tricare tell me that it is on the government "no pay" list. We are billing with appropriate well child visit and vaccine administration codes, as well as modifier -25 on the well visit, the same as any other well visit with immunizations. Is anyone having trouble getting these codes paid as part of well child coverage?

Pam Bowman, CPC

 

[csantiago]

Unfortunately, Tricare will not pay for 90687 with dates of service prior to 09/20/2014. This code was just removed from the "Government No Pay List".