Medical Billing and Coding for Flu Vaccine Administration Providers should keep tabs on the available flu vaccines and also ensure accurate documentation through proper vaccination coding.
Outsource Strategies International 8596 E. 101st Street, Suite H Tulsa, OK 74133
www.outsourcestrategies.com | 1-800-670-2809
With the new flu season (October to May) drawing near, providers are gearing up for timely vaccine administration for their patients. The Centers for Disease Control and Prevention (CDC) recommends flu vaccine administration as the crucial step to achieve immunity from this epidemic. It is very important to get vaccinated as soon as the vaccine becomes available, if possible by October. Healthcare providers should now keep tabs on the available vaccines and also pay attention to correct medical billing and coding for vaccinations.
Vaccines can change during each flu season according to the particular influenza strains the CDC and other public health officials expect that season. Flu and vaccination coding depends on those vaccines. As per the CDC, both trivalent and quadrivalent influenza vaccine will be available this season with different routes of administration including intramuscular, intradermal, jet injector and nasal spray. To be more specific, this season:
Intramuscular vaccines will be available in trivalent and quadrivalent formulations while high dose vaccines will be trivalent.
For people in the age group 18 to 64, a jet injector can be used for delivery of one particular trivalent flu vaccine (AFLURIA® by bioCSL Inc.)
Nasal spray vaccines and intradermal vaccine will all be quadrivalent.
Flu Vaccine Documentation and Coding
Providers should document the following vaccine information on patients’ charts in order to choose the correct influenza vaccine codes.
www.outsourcestrategies.com
800-670-2809
Patient’s age
Specify whether the vaccine is active or inactivated, recombinant or live attenuated
Specify whether vaccine is trivalent (abbreviated IIV3, for inactive influenza vaccine, trivalent) or quadrivalent (abbreviated IIV4, for inactive influenza vaccine, quadrivalent)
Preservative status of the vaccine (presence of thimerosol and mercury content)
Dosage and route of administration
Different types of vaccine codes effective from January 2015 are as follows:
90630: Influenza virus vaccine, quadrivalent (IIV4), split virus, preservative free, for intradermal use, ages 18-64 only
90654: Influenza virus vaccine, trivalent (IIV3), split virus, preservative free, for intradermal use, ages 18-64 only
90655: Influenza virus vaccine, trivalent (IIV3), split virus, preservative free, for children 6-35 months of age, for intramuscular use
90656: Influenza virus vaccine, trivalent (IIV3), split virus, preservative free, for use in individuals 3 years and above, for intramuscular use
90657: Influenza virus vaccine, trivalent (IIV3), split virus, for children 6-35 months of age, for intramuscular use
90658: Influenza virus vaccine, trivalent (IIV3), split virus, for use in individuals 3 years of age and above, for intramuscular use
www.outsourcestrategies.com
800-670-2809
90660: Influenza virus vaccine, trivalent (LAIV3), live, for intranasal use, ages 249 years only
90661: Influenza virus vaccine (ccIIV3), derived from cell cultures, subunit, preservative and antibiotic free, for intramuscular use, ages 18-99 only
90662: Influenza virus vaccine (IIV), split virus, preservative free, enhanced immunogenicity via increased antigen content, for intramuscular use, ages 65 and older only
90672: Influenza virus vaccine, quadrivalent, live (LAIV4), for intranasal use, ages 2-49 only
90673: Influenza virus vaccine, trivalent (RIV3), derived from recombinant DNA (RIV3), hemagglutinin (HA) protein only, preservative and antibiotic free, for intramuscular use, ages 18-49 only
90685: Influenza virus vaccine, quadrivalent (IIV4), split virus, preservative free, when administered to children 6-35 months of age, for intramuscular use, ages 6-35 months only
90686: Influenza virus vaccine, quadrivalent (IIV4), split virus, preservative free, when administered to individuals 3 years of age and older, for intramuscular use, ages 3-99 years only
90687: Influenza virus vaccine, quadrivalent (IIV4), split virus, when administered to children 6-35 months of age, for intramuscular use, ages 3-35 months only
www.outsourcestrategies.com
800-670-2809
90688: Influenza virus vaccine, quadrivalent (IIV4), split virus, preservative free, when administered to individuals 3 years of age and older, for intramuscular use, ages 3-99 years only
Q2034: Agriflu influenza virus vaccine, split virus, for intramuscular use, ages 1899 years only
Q2035: Afluria influenza virus vaccine, split virus, for use in individuals 3 years of age and above, for intramuscular use
Q2036: Flulaval influenza virus vaccine, split virus, for use in individuals 3 years of age and above, for intramuscular use
Q2037: Fluvirin influenza virus vaccine, split virus, for use in individuals 3 years of age and above, for intramuscular use
Q2038: Fluzone influenza virus vaccine, split virus, for use in individuals 3 years of age and older, for intramuscular use
Q2039: Influenza virus vaccine, split virus, when administered to individuals 3 years of age and older, for intramuscular use (not otherwise specified)
New Category I Vaccination Codes
The American Medical Association (AMA) recently published a list of 2016 CPT Category I Vaccine codes, which includes a number of new vaccination codes.
90620: Meningococcal recombinant protein and outer membrane vesicle vaccine, Serogroup B, 2 dose schedule, for intramuscular use (FDA approved)
www.outsourcestrategies.com
800-670-2809
90621: Meningococcal recombinant lipoprotein vaccine, Serogroup B, 2 or 3 dose schedule, for intramuscular use (FDA approved)
90651: Human Papillomavirus vaccine types 6, 11, 16, 18, 31, 33, 45, 52, 58, nonavalent (HPV), 3 dose schedule, for intramuscular use (FDA approved)
90697: Diphtheria, tetanus toxoids, acellular pertussis vaccine, inactivated poliovirus vaccine, Haemophilus influenza type b PRP-OMP conjugate vaccine, and hepatitis B vaccine (DTaP-IPV-Hib-HepB), for intramuscular use (awaiting FDA approval)
Vaccine Administration Codes
You should report the appropriate vaccine administration codes from the following series, apart from the vaccine code.
90471: Immunization Administration, one injection (Do not report with 90460 or 90473)
+90472: Immunization Administration, each additional injection
90473: Immunization Administration by intranasal/oral route; one vaccine (Do not report with 90460 or 90471)
+90474: Immunization Administration by intranasal/oral route; each additional vaccine
Keep up to date with the coding guidelines specified by different healthcare plans also to ensure effective medical coding. Providers can save the effort and time involved in
www.outsourcestrategies.com
800-670-2809
streamlining the medical billing process with efficient external support from a reliable billing firm. Experienced medical billing and coding companies continue to support healthcare entities providing value-added service with their AAPC-certified medical coders.
www.outsourcestrategies.com
800-670-2809