It is not inclusive it has its own code,
90663 Influenza virus vaccine, pandemic formulation, H1N1 to report the H1N1 vaccine product,
and newly created code
90470 H1N1 immunization administration (intramuscular, intranasal), including counseling when performed to report H1N1 immunization administration and counseling.
For Medicare, report
G9142 Influenza A (H1N1) vaccine, any route of administration to describe the H1N1 vaccine itself and
one unit of
G9141 Influenza A (H1N1) immunization administration (includes the physician counseling the patient/family) to describe each administration of the H1N1 vaccine. Beneficiary copayment and deductible do not apply to HCPCS code G9141.
The G codes are for Medicare and any other payer that wants as they are carrier discretion.
Also from CMS:
Neither of these revisions are in the 2010 CPT manual but were
active codes as of September 28, 2009.
Note: 90470 is a code which was deleted in 1999. It was revitalized
and is now a new and different code. Some of the reimbursement
issues may be due to its deleted status.
To report the administration of 2009 H1N1 influenza type A
monovalent vaccine, providers should report CPT code 90663
(Influenza virus vaccine, pandemic formulation, H1N1) in
conjunction with the immunization administration code 90470 (H1N1
immunization administration (intramuscular, intranasal), including
counseling when performed). Providers will be paid for 2009 H1N1
vaccine administration. Since the 2009 H1N1 vaccine will be
provided free of charge, no payment will be issued for 90663.
CMS guidance for reporting the charge of the 2009 H1N1 vaccine
product on the claim form is that zero dollars should be listed
following code 90663. Other payer plans may vary. For payer
requirements, see the payer-specific web sites for further billing
In the event that a seasonal flu vaccination is administered in addition
to the H1N1 vaccination at the same visit, it is necessary that code
90470 should be reported for the initial administration service for the
H1N1 vaccine product, and either code 90466, 90468, 90472, or
90474 for the additional administration service. The H1N1 vaccine
administration code should not be reported in addition to the initial
service vaccine administration codes 90465, 90467, 90471, and
90473 because these changes were made after the publication of the
2010 CPT manual and therefore the add on vaccine administration
codes have not been updated to include 90470. To reiterate, these
changes were made after the publication of the 2010 CPT manual.
Therefore, the instructional notes following the add-on vaccine
administration codes have not been updated to include 90470 in the
list of primary procedures. However, appropriate reporting of
multiple vaccine administrations is to report one initial administration
code and the appropriate add-on administration code(s) 90466,
90468, 90472, or 90474 for the additional administration(s). Be sure
to check with your payer or visit the AMA H1N1 Web site for a
listing of payer billing requirements
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