It’s time to update your seasonal influenza vaccine roster for the 2018-2019 season.
Medicare provides coverage of the flu vaccine once per season (or more, if medically necessary) without any out-of-pocket cost to the Medicare patient. No deductible or co-payment/coinsurance applies. Healthcare providers are reimbursed for the vaccine and its administration.
The administration code for the seasonal influenza virus vaccine is HCPCS Level II G0008 Administration of influenza virus vaccine and the ICD-10-CM diagnosis code is Z23 Encounter for immunization.
Here are the CPT codes and payment allowances for the 2018-2019 flu vaccines.
Payment Allowances and Effective Dates for the 2018-2019 Flu Season
Source: www.cms.gov
Note that newly-released CPT code 90689 Influenza virus vaccine quadrivalent (IIV4), inactivated, adjuvanted, preservative free, 0.25 mL dosage, for intramuscular use, is not on the list. This code was just accepted by the CPT Editorial Panel in May and is not effective until Jan. 1, 2019.
See the MLN booklet Mass Immunizers and Roster Billing for Influenza Virus and Pneumococcal Vaccinations for complete coding and billing guidelines.
Related Reading on the Knowledge Center:
How to Code Flu – from Prevention to Care
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