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Thread: Influenza Vaccine

  1. #1
    Join Date
    Apr 2007
    Location
    Ocala
    Posts
    24

    Default Influenza Vaccine

    Promo: Code Books
    I'm trying to see if anyone knows of another code for the flu vaccine. I thought as of the first of the year we were to replace 90658 with Q2035? Also, when I look this code up on the Medicare website it says it's not payable. Is anyone else having this problem? Any solutions?

  2. #2
    Join Date
    Apr 2007
    Location
    Austin, TX
    Posts
    4

    Default

    I work in a pediatric practice, and we bill 90657-flu vaccine ages 6months to 35 months, 90658-flu vaccine 3 years and older, and 90660-flu mist. As far as I know, all of these codes are the same as last year, and we are already using them. Do you work in physician or facility coding? Perhaps there is a difference... Hope this helps!

  3. #3
    Join Date
    Apr 2007
    Posts
    24

    Default

    New flu codes are for the exact antigen you are using. Per Medicare as of Jan 1, 2011 new flu codes are as follows:

    Q2035 Afluria "influenza virus vaccine, split virus, when administered to individuals 3 years of age or older, for intramuscular use"

    Q2036 Flulaval "influenza virus vaccine, split virus, when administered to individuals 3 years of age or older, for intramuscular use"

    Q2037 Fluvinin "influenza virus vaccine, split virus, when administered to individuals 3 years of age or older, for intramuscular use"

    Q2038 Fluzone "influenza virus vaccine, split virus, when administered to individuals 3 years of age or older, for intramuscular use"

    Q2039 "influenza virus vaccine, split virus, when administered to individuals 3 years of age or older, for intramuscular use" NOT OTHERWISE SPECIFIED
    Kimberly Jawidzik, CPC
    MedAssure, LLC
    Physician Billing & Consulting
    www.MedAssureLLC.com
    KimJ@MedAssureLLC.com

  4. #4

    Default

    Can anyone tell me about the codes for regular commercial insurance companies. Do we use the same codes as the Medicare codes in addition to the G0008.

  5. #5
    Join Date
    Apr 2007
    Location
    Ocala
    Posts
    24

    Default Reply

    We've had the same problem. The Q code isn't payable in Florida. I've yet to find a solution.

  6. #6

    Default

    We are in Florida. We bill Q2036 for the actual vaccine and G0008 for Medicare patients for the administration and 90471 for all others. I haven't seen any denials for non-payment or non-covered as of yet, but it is still early!

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