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Sep 15th, 2017 - ciaperek

flu vaccine

We have new flu vaccine- 4 strains. Name of vacc. Flucelvax quadrivalent. Can we use different code since vaccination is much better and more expensive? Or we use 90658?

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Sep 18th, 2017 - ChrisW   42  1 

New influenza code

For the new Influenza virus vaccine, quadrivalent (ccIIV4), there is a new code for use 90674 beginning January 2017.


CMS recently announced that there were some delays on billing the new CPT code for influenza vaccine Flucelvax (CPT code 90674.) Even though the code became effective on August 1, 2016, Medicare claims processing systems did not begin to accept the new code until January 1, 2017.

For professional claims, there are two possible options for billing this service prior to January 2017:

Hold claims containing CPT code 90674 and then submit them after January 1st.
Check to see if your MAC will allow you to use a Not Other Classified (NOC) code to bill for the vaccine for dates of service on or after August 1, 2016, and before January 1, 2017.

Please note that for institutional claims (UB-04), code 90674 was implemented on February 20, 2017.

References:https://www.cms.gov/Outreach-and-Education/Outreach/FFSProvPartProg/Provider-Partnership-Email-Archive-Items/2016-10-06-eNews.html#Billing%20for%20Influenza:%20New%20CPT%20Code%2090674

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