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The new Influenza/H1N1 vaccine

  1. #1
    Location
    New Braunfels, Texas
    Posts
    25
    Default The new Influenza/H1N1 vaccine
    Medical Coding Books
    Hi everyone, this is my first time on the forum. Does anyone out there know what codes to use to bill out the new Influenza/H1N1 vaccination? CDC is saying one thing, and payors are saying something else.

  2. #2
    Location
    Naples Florida
    Posts
    140
    Smile
    Are you talking about the high dose influenza or the combination of influenza and H1N1. I work for a state health department and have not heard of the combo code, but I under stood that the H1N1 was going to be in the flu shot.

  3. #3
    Location
    New Braunfels, Texas
    Posts
    25
    Default
    It is the combination (Influenza & H1N1).

  4. #4
    Location
    Greeley, Colorado
    Posts
    2,045
    Default
    It is my understanding that all influenza vaccines now also contain H1N1 so the codes are the same as last year for the influenza vaccines.
    Lisa Bledsoe, CPC, CPMA

  5. Default Influenza/H1N1
    I checked on line and the code is 90662 (Fluzone High-Dose) for 65 yrs and over I believe the Medicare allowed amount is $29.21.

  6. #6
    Location
    Sioux Falls South Dakota
    Posts
    358
    Default
    Quote Originally Posted by meggleston View Post
    I checked on line and the code is 90662 (Fluzone High-Dose) for 65 yrs and over I believe the Medicare allowed amount is $29.21.
    Only the high dose for 65 and older is 90662; and currently, that code is being held by Medicare until after the updates on 10/01/10.

    The seasonal flu shot this year includes H1N1 and two others (it always includes three), so you would use the regular flu shot codes (90655-90658, depending on formulation, age, preservative free, etc.).

    You would not use the pandemic codes - those are now reserved for any future pandemic that would be given separately from the seasonal flu vaccine.

    Also, I have a suggestion for those who are new to the forums. There is a search function. During the past couple of months, there have been many posts and responses about the flu shots. If you search by key words such as influenza, H1N1, flu, etc, you could find the other posts. This is not to be in any way critical. When I have a question, I always do a search first, in case it's already been asked and answered.

    I hope this helps!
    Lucinda (Cindy) McGarry, CPC-P
    Applications Specialist
    Avera Health Plans
    Education Office Sioux Falls SD Local Chapter
    Past President Sioux Falls SD Local Chapter

  7. #7
    Location
    New Braunfels, Texas
    Posts
    25
    Default
    Thanks to all for the info. Good tip on the search.

  8. #8
    Default Intranasal Influenza/H1N1/H2N3 immunization
    Thanks for all the helpful info on this subject but I have an additional question - would 90660 be used for intranals administration of these vaccines?

  9. #9
    Location
    Sioux Falls South Dakota
    Posts
    358
    Default
    Quote Originally Posted by kjlowell View Post
    Thanks for all the helpful info on this subject but I have an additional question - would 90660 be used for intranals administration of these vaccines?
    90660 is not the administration code, but the code for the actual intranasal vaccine itself. For the administration intranasally, your code would be 90473 if the initial or only vaccine, 90474 for subsequent.
    Lucinda (Cindy) McGarry, CPC-P
    Applications Specialist
    Avera Health Plans
    Education Office Sioux Falls SD Local Chapter
    Past President Sioux Falls SD Local Chapter

  10. #10
    Location
    Covington, LA
    Posts
    89
    Default high dose flue
    Are we still to use the diagnosis code V04.81 (vaccination for influenza) on the high dose flu. I have heard some coders using V04.89 (other viral vaccination). My understanding is that it is still an influenza vaccination just a stronger dose.

    Please advise,
    Angie

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