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Author:
Codapedia Editor
H1N1--New Codes from CMS for Sept 1 2009 Swine flu
Citations: No citations found
Resources: Revised MedLearn Matters article (pdf)   MedLearn Matters article (pdf)   CMS article (pdf)  
Total Reviews: 1
Current Rating: ••••••••••

On CMS's Open Door Forum call, today, 8/25/09, CMS said:

* Change request and MedLearn Matters articles will be coming soon

* There will be new codes for the administration/vaccine

* Vaccine will be available in mid-October, provider community will have access to it

* Vaccine will be FREE: do not bill Medicare for vaccine

* Will be able to bill for vaccine administration, same fee as administration for seasonal flu

INFO at:

http://www.cms.hhs.gov/Emergency/10_PandemicFlu.asp#TopOfPage

When the change request and MLM articles are posted, we will summarize here and post.

TWO NEW CODES

G9142 is for the vaccine itself: Influeza A (H1N1) vaccine, any route of administration.  Remember, if you receive the serum free, don't bill/report this code.

G9141 Influenza A (H1N1) immunization administration (includes the physician counseling of the patient/family)  Report one unit/beneficiary for each administration.  Copay and deductible will not apply to code G9141.

CPT® codes

90470—H1N1 immunization administration (intramuscular, intranasal), including counseling when performed
90663—Influenza virus vaccine, pandemic formulation, H1N1
 

Check with your commercial carriers about how to code: Using CPT® or HCPCS

 

Printable Version

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  • Click Here to Comment, Clarify and Rate this Article

    jlebeau
    Mon, Sep/21/2009
    Ratings: •••••
    commercial admin code?
    what administration code are we supposed to use for non-Medicare payers? I've read a few different viewpoints on this - some say to use 90471, some say 90663 (pandemic)? If we are vaccinating for regular flu and H1N1 on the same visit, if we use 90471 with V04.81 twice, won't we be getting into duplicate issues?

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