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H1N1 Vaccine

  1. #11
    Medical Coding Books
    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:
    The President declares an emergency or disaster under the National Emergencies Act or the Stafford Act; and
    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
    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.
    TJ Smith, CPC
    Cheyenne Physicians Group
    Cheyenne, WY

  2. Default 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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