CPT 2011 Brings Changes to Flu Vaccines and Counseling Codes, Deletes 90658

This year, your vaccine coding will be action-filled thanks to changes in codes and administration reporting. Two more updates every FP should now involve new Q codes for some Medicare flu vaccines and expanded ages for adolescent vaccine counseling.

Nix 90658 for Medicare Patients this year

CMS has come up with new HCPCS codes (Source "http://www.supercoder.com/hcpcs-codes") and payment allowances to replace 90658. Effective January 1, Medicare will no longer pay for; as such, choose from the new codes instead, based on the specific product: Q2035, Q2036, Q2037, Q2038 and Q2039.

Timing: Codes Q2035-Q2039 went into effect on Oct. 1, last year. When filing claims for dates of service from October 1 to December 31, last year, you had two code choices: To bill Medicare right away with 90658 or hold the claim until January 1, 2011 and file with the proper Q code. For vaccines administered now, post January 2011, you should only report the applicable Q code.

Use 90460, +90461 through age 18

Thanks to CPT, you will be able to use medicine series vaccine administration with counseling codes on older patients and when a nurse provides the counseling.

As counseling for adolescents can involve as much time as counseling on vaccines for younger children, the American Academy of Pediatrics recommended that the age limitation on the vaccine administration with counseling codes be raised. New codes extend vaccine administration with counseling to patients through 18 years of age.

Take advantage of RN/LPN Counseling and still get the payments

Busy practices will be thrilled at being able to use their registered nurses (RN) or licensed practicing nurses (LPN) to capture the higher relative value units (RVU) some private payers associate with the vaccine administration with counseling codes. The just-in vaccine administration with counseling code descriptor expands who can provide the vaccine counseling described in the deleted immunization administration with vaccine counseling codes (90465-90468). Earlier, CPT 2010 vaccine administration with counseling codes 90465-90468 limited the counselor role to a physician and, subject to state scope of practice laws, nurse practitioner or physician assistant.

The just-in vaccine administration with counseling code extend the counseling opportunity to any 'qualified health care professional' practicing within his/her state described scope of practice. An RN, LPN or medical technician could provide the counseling and the practice could still use the vaccine administration with counseling code.