H1N1--New Codes from CMS for Sept 1 2009 Swine flu

October 16th, 2009 - Codapedia Editor
Categories:   Primary Care|Family Care   Coding  
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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:


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


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



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