Cpt Code 90685 Descriptive Essay

Billing Flu Shots to Medicare and Commercial Insurance Companies

Since it is now flu season I have been getting a lot of questions on how to bill flu shots to commercial insurance companies and Medicare. The codes used for a particular vaccine will vary depending on intramuscular vs. intranasal use, age of patient, formulation, preservative free, and split or live virus. If you are unsure of what code to use I suggest looking at the package information
that came with the vaccine. Usually you can find the code on the packaging, and if you can’t find it in the documentation then call the supplier.

This is how most of our primary care practices bill for flu shots. Your situation may be different so make sure to check all the influenza vaccine codes 90654-90668 and use the appropriate code for the vaccine administered to the patient.

Commercial Insurance Carriers

90471Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections); 1 vaccine (single or combination vaccine/toxoid)
90658Influenza virus vaccine, split virus, when administered to individuals 3 years of age and older, for intramuscular use

Medicare

G0008Administration of Influenza Virus Vaccine
Q203xInfluenza virus vaccine, split virus, when administered to individuals 3 years of age and older, for intramuscular use

Keep in mind that there are several codes for the flu vaccine when you bill for Medicare flu shots. The code you use is dependent on the manufacturer of the vaccine. Replace the code above with the correct vaccine code below.

Here is the list of the Medicare Flu Vaccine codes. Choose the code based on the manufacture:

Q2034 Agriflu Vaccine: Influenza virus vaccine, split virus, for intramuscular use (Agriflu)

Q2035 Afluria Vaccine: Influenza virus vaccine, split virus, when administered to individuals 3 years of age and older, for intramuscular use (Afluria)

Q2036 Flulaval Vaccine: Influenza virus vaccine, split virus, when administered to individuals 3 years of age and older, for intramuscular use (Flulaval)

Q2037 Fluvirin Vaccine: Influenza virus vaccine, split virus, when administered to individuals 3 years of age and older, for intramuscular use (Fluvirin)

Q2038 Fluzone Vaccine: Influenza virus vaccine, split virus, when administered to individuals 3 years of age and older, for intramuscular use (Fluzone)

Q2039 NOS (Not Otherwise Specified) Vaccine: Influenza virus vaccine, split virus, when administered to individuals 3 years of age and older, for intramuscular use (Not Otherwise Specified)

Check out the short video we made about coding for the Medicare flu shot CLICK HERE

Pediatric Billing

If a child is under the age of 9 and has not previously received a flu shot, then usually two shots are given one month apart. After the initial series, in subsequent years only one shot is needed. When billing for the initial flu shot keep in mind that insurance should pay for both the initial flu shot and the flu shot given 30 days later. Be sure to follow up with the insurance companies if reimbursement is not issued for the second shot of the initial series. Typically these are denied but can be paid with a simple appeal or phone call correcting the denial.

90471Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections); 1 vaccine (single or combination vaccine/toxoid)

Use the age appropriate codes as needed.
90657Influenza virus vaccine, split virus, when administered to children 6-35 months of age, for intramuscular use
Or
90658Influenza virus vaccine, split virus, when administered to individuals 3 years of age and older, for intramuscular use

CPT copyright 2010 American Medical Association. All rights reserved.
CPT is a registered trademark of the American Medical Association.

Manny Oliverez

+Manny Oliverez is a 20 year veteran of healthcare having managed medical practices. He advises medical practices, physicians and practice administrators on how to run their practice and manage their medical billing and revenue cycle management. Manny speaks, blogs and makes videos at www.CaptureBilling.com, a blog that is tops in the medical billing and coding field. READ MORE

Filed Under: How to Bill for Flu Vaccine, Medical Billing and Coding Topics

Ничего не понимают в системах безопасности. Присяга, которую Чатрукьян принимал, поступая на службу в АНБ, стала непроизвольно прокручиваться в его голове. Он поклялся применять все свои знания, весь опыт, всю интуицию для защиты компьютеров агентства, стоивших не один миллион долларов. - Интуиция? - с вызовом проговорил .

One thought on “Cpt Code 90685 Descriptive Essay

Leave a Reply

Your email address will not be published. Required fields are marked *