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Thread: Billing for Flu vaccine CPT codes?

  1. #1

    Default Billing for Flu vaccine CPT codes?

    The insurance companies keep rejecting the CPT codes for the flu vaccines I submit.

    So I wanted to know what the right way was for billing for CPT codes 90655, 90656 and 90660 (which is the flumist)

    Or do I always have to indicate the prophylaxis code in the ICD 9 section which is V04.81? Because I haven't exactly been doing that.

  2. #2

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    You must use the DX code V04.81. It specifys exact what the service was for. Have found it gets paid more quickly that way.

  3. #3

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    Hi. What administration codes should I use for the flu vaccine? We use Fluvirin which is Q2037. For Medicare, I bill a G0008 but what about private pay? Should I be using 96372?

    Any help is appreciated. Thank you!

  4. #4
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    Quote Originally Posted by ReginaR View Post
    Hi. What administration codes should I use for the flu vaccine? We use Fluvirin which is Q2037. For Medicare, I bill a G0008 but what about private pay? Should I be using 96372?

    Any help is appreciated. Thank you!
    No - 96372 is for drug administrations (J-codes) only - Vaccine admins for commercial payers should be billed with either 90471 (when no counseling is provided, and for all patients over age 18) or 90460 for patients under 18, when counseling is provided.

    Hope that helps!

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  6. #6

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    Quote Originally Posted by mallorymartinelli View Post
    You must use the DX code V04.81. It specifys exact what the service was for. Have found it gets paid more quickly that way.
    Thank you

  7. #7

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    Ok what about if I was billing the flu vaccine with sick visit codes? Do I still note the v04.81 code along with the sick visit codes?

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