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2010-11 Influenza Season
Academy Answers Member Inquiries on Flu Vaccine Coding, Billing
By Sheri Porter
- There is no separate and specific code for the novel influenza A (H1N1) vaccine this year because the 2010-2011 seasonal influenza vaccine includes the H1N1 strain.
- Physicians should report two codes to bill for influenza vaccination services: the appropriate CPT code for the flu vaccine given and the appropriate CPT code for vaccine administration. A complete list of CPT codes pertinent to the 2010-2011 influenza season is included in Family Practice Management's "Getting Paid" blog entry Organize to Immunize - Flu Season Is Coming, which posted on Aug. 26.
- This is the first year that the CDC's Advisory Committee on Immunization Practices has recommended that influenza vaccinations be given to all people ages 6 months and older in whom the vaccine is not contraindicated.
- Physicians should use CPT code 90662 when billing for Fluzone High-Dose, a new flu vaccine approved in December 2009 for use in people ages 65 and older.
- Seasonal flu vaccination is an annual benefit for Medicare beneficiaries; however, a beneficiary could conceivably receive a seasonal influenza vaccination twice in one calendar year for two different flu seasons. In that situation, physicians can bill -- and will be paid -- for both vaccine services.
The MLN Matters issue contains a plethora of Web links leading to current influenza articles, resources and other information. CMS also reminds physicians about some common-sense influenza strategies, such as
- use each office visit as an opportunity to encourage patients to get a flu shot;
- provide the seasonal flu shot as long as vaccine is available, even after the new year; and
- ensure that every physician and staff person in the office gets a flu shot.
Groups Call for Mandatory Flu Vaccinations for Health Care Workers
Immunization is Professional, Ethical Obligation, Says SHEA, AAP
AAFP, Other Groups Stress Need for Pregnant, Postpartum Women to Be Immunized Against Flu
Expectant Mothers at High Risk for Influenza Complications
CMS: Seasonal Influenza Vaccines Pricing
Medicare Preventive Services Quick Reference Information
(2-page PDF; About PDFs)