Flu season will be here before we know it and that means that there will be an increase of patients coming into the doctor to seek medical care. Being prepared for the billing that will come with the influx of patient visits will help you stay on top of paperwork and process medical claims faster. Situations from practice to practice can be different, so be sure to check the flu vaccine codes that range from 90654-90668 to see which code is most appropriate for the patient. Here are some of the basic facts to know about billing for flu vaccines.
Commercial insurance carriers:
Most oftentimes, there are two codes that are used. The immunization administration code of 90471 is often used because it includes percutaneous, intradermal, subcutaneous, or intramuscular injections. The next code is 90658 and it involves administering the flu virus vaccine to patients that are 3 years old and up.
For patients that are using Medicare benefits, medical billing codes can include Q203x or G0008, both of which are used for administering the flu virus via vaccine. There are more flu vaccine codes that can be used as well, depending on the manufacturer of the vaccine. These could include Afluria, Flulaval, Fluvirin, or Fluzone. Keep in mind that the Q2039 code can be used if the vaccine name is not otherwise specified.
For children that are under age 9 that have not had a flu shot previously, there are usually two shots that are given one month apart. After the initial series, the years following only requires one shot. But for the initial two shots, insurance should pay for both, but you will need to be sure to follow up with the insurance company if reimbursement is not issued for the final shot in the series. They are often denied, but this can be fixed if you take a little bit of extra time to appeal or make a phone call to explain the situation. The two main codes used for pediatric flu shots are the 90657 and 90685 codes.
Do you have additional questions on billing for influenza vaccines or need additional help on using the medical billing system for your practice? Contact our professional and experienced team at MBA Medical and we’ll help get you the additional information you need to allow you to develop an office culture that has extremely efficient billing practices.