CPT® 2012 Contains Intradermal Flu Vaccine Option With 90654

Don't overlook revisions to other vaccine, E/M codes.

CPT® 2012 will go into effect in a few weeks, so you must prepare yourself now for new and revised choices associated with vaccine administration and prolonged E/M service to make sure your claims stay correct. Read this article for an ICD-9 and CPT 2012 expert insight for accurate claims and maximized ethical reimbursement.

Official Addition of 90654

CPT® 2012 adds a different option to your flu vaccine coding by adding 90654 (Influenza virus vaccine, split virus, preservative-free, for intradermal use). The inclusion expands on the code family 90655-90668 that at present addressed influenza vaccines.

A couple of factors separate 90654 from a lot of of the other flu vaccine codes:

Code 90654 is not age specific, while codes 90655-90658 do identify the patient's age (either 6 to 35 months of age, or age 3 years and older).

Code 90654 denotes an intradermal injection (administered to the dermal layer of skin), however additional codes (e.g. 90655-90658 and 90662) describe intramuscular injections (administered to muscle tissue) as well as intranasal administration (e.g. 90660).

ICD-9 and CPT Tip: Code 90654 signifies just the vaccine product. Include the fitting administration code (90460-90474) on your claim. In case your physician delivers a noteworthy, distinctly identifiable E/M service in the encounter for the vaccine, also report the suitable E/M code (99201-99205 for a new patient or 99211-99215 for an established patient).

Though 2012 will be the first time 90654 is covered in the CPT® book, the code has been present for more than a year.

Ace ICD-9 and CPT 2012: Note Extra Specificity of 90460-90461

A number of additional vaccine as well as vaccine administration codes go through revision for CPT® 2012. Revised codes involve (underline indicates change):

90460 -- Immunization administration over 18 years of age through any route of administration, including counseling by a physician or added qualified health care professional; first or only component of each vaccine or toxoidadministered.

+90461 -- ... every single additional vaccine or toxoid component which is administered (List separately in addition to code for primary procedure)

90581 -- Anthrax vaccine, meant for subcutaneous or intramuscular use

90644 -- Meningococcal conjugate vaccine, as well as serogroups C & Y along with Hemophilus influenza B vaccine (Hib-MenCY), a 4 dose schedule, while administered to children who are 2-15 months of age, for intramuscular use.

ICD-9 and CPT Expert Tip: CPT 2012 removes vaccine codes 90470 (H1N1 immunization administration [intramuscular, intranasal [including counseling when performed) and 90663 (Influenza virus vaccine, pandemic formulation, H1N1). These codes were possibly considered no longer required, particularly with the inclusion of codes 90664-90668 in 2011.

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