| It's time to start thinking about flu shots again. Today's | | | | biologicals (not in the physician fee schedule as of this |
| post is just a short primer on the appropriate CPT and | | | | posting) but no posting for G0008. Although they did |
| ICD-9 codes utilized in those immunizations. | | | | post the following in their newsletter Part B Medicare |
| For intranasal mist the code is 90660 with an | | | | News for October 20, 2008 |
| administration code of 90473. Medicare of Georgia | | | | October Flu Shot Reminder |
| allows $22.031 in the drugs and biologicals but does not | | | | Flu Season Is Upon Us! Begin now to take advantage |
| approve any payment for the vaccine under the | | | | of each office visit as an opportunity to encourage |
| physician fee schedule and has no approved amount | | | | your patients to get a flu shot. It's still their best |
| for the administration code. California BCBS does not | | | | defense against combating the flu this season. |
| approve either, but the federal FEP does approve the | | | | (Medicare provides coverage of the flu vaccine |
| vaccine but will not pay for the administration. In 2004 | | | | without any out-of-pocket costs to the Medicare |
| California BCBS did cover the service but said it was | | | | patient. No deductible or copayment/coinsurance |
| as a result of there being a shortage of available IM | | | | applies.) And don't forget, health care personnel can |
| vaccine. | | | | spread the highly contagious flu virus to patients. |
| Intramuscular vaccines are listed as four codes:o | | | | Protect Yourself. Don't Get the Flu. Don't Give the Flu. |
| 90655 Influenza virus vaccine, preservative free, for | | | | Get Your Flu Shot. |
| ages 6-35 months IMo 90656 Influenza virus vaccine, | | | | Remember - Influenza vaccine plus its administration |
| preservative free, for ages 3 years and above IMo | | | | are covered Part B benefits. Note that influenza |
| 90657 Influenza virus vaccine, for ages 6-35 months | | | | vaccine is NOT a Part D covered drug. |
| IMo 90658 Influenza virus vaccine, for ages 3 years | | | | The ICD-9 codes for these procedures are:o V04.81o |
| and above IM | | | | V06.6 - Purpose of visit was to receive both PPV and |
| Administration codes are 90741 for CPT and G0008 | | | | Flu vaccines (effective 10/1/06) |
| for Medicare. As of this posting, Medicare for Georgia | | | | Hope this helps with the flu vaccine for the current |
| has posted approved payment amounts in their | | | | year. Your medical billing staff should have all the tools |
| schedule of $13.218 for 90658 under drugs and | | | | necessary to get you paid. |