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Flu Vaccination

  1. #1
    Default Flu Vaccination
    Medical Coding Books
    Can anyone explain the ICD 9 code 99.52?
    My providers have been using it for the diagnosis code for flu shots and my claims edit software will not allow the claim to go out. I have no clue where they got the code or why they are using it. Thanks

  2. Default
    This is an ICD-9 Procedure code, found in volume 3 of the ICD-9 manual:

    99.52 Prophylactic vaccination against influenza

    If the intent was to report a diagnosis code, you might want to look at:

    V04.81 Need for prophylactic vaccination and innoculation against Influenza

    Hope this helps,
    Anthony McCallum, CPC, CIRCC, CPC-I, CCS
    ciphermed@optonline.net

  3. #3
    Default
    That was what I thought from my research. Thanks, I'll let folks know to stop using it. Do you know when it is ok to use that as the procedure instead of the 90658, or other vacc. code?

  4. Default
    Those codes are usually used for facility billing.

  5. Default
    I believe that it is a requirement on facility ambulatory sugery and inpatient cases....

    Hope this helps,
    Anthony McCallum, CPC, CIRCC, CPC-I, CCS
    ciphermed@optonline.net

  6. #6
    Location
    Columbia, MO
    Posts
    12,526
    Default
    Volume 3 ICD-9 is used by inpatient facility coders only. These are for procedures performed when the patient is in an inpatient setting and reported by the facility. Outpaitent and physician coders as well as ASC do not use volume 3 at all, they use CPT. With ICD-10, volume 3 will no longer exist, facility inpatient will use ICD-10 PCS codes for inpatient procedures.

    Debra A. Mitchell, MSPH, CPC-H

  7. #7
    Default
    Yes, helps alot. Thanks bunches.
    Have a great rest of the week

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