Ensure Payment for Your Vaccine Services

While it is true that some of the CPT codes used to report vaccinations are to be deleted, they can be billed through December 31, 2012. They will be deleted only in 2013, the AMA ensures. If a payer is denying claims for codes 90718 (Tetanus and diphtheria toxoids adsorbed when administered to individuals 7 years or older, for intramuscular use), 90665 (Lyme disease vaccine, adult dosage, for intramuscular use) and 90701 (Diphtheria, tetanus toxoids, and whole cell pertussis vaccine [DTP], for intramuscular use), you can send them a copy of the AMA’s clarification regarding this along with your appeal. The AMA, in their coding alert put up on their website has clearly stated that these codes will remain effective for reporting through December 31, 2012.

New CPT Codes for Influenza Virus Vaccine

CPT® 2014 will have four additional codes that are to be used to report influenza virus vaccine. These codes will however, be effective from 2013.

• 90685 – Influenza virus vaccine, quadrivalent, split virus, preservative free, when administered to children 6-35 months of age, for intramuscular use
• 90686 – Influenza virus vaccine, quadrivalent, split virus, preservative free, when administered to individuals 3 years of age and older, for intramuscular use
• 90687 – Influenza virus vaccine, quadrivalent, split virus, when administered to children 6-35 months of age, for intramuscular use
• 90688 – Influenza virus vaccine, quadrivalent, split virus, when administered to individuals 3 years of age and older, for intramuscular use

FDA Has Approved Code 90644

CPT code 90644 (Meningococcal conjugate vaccine, serogroups C & Y and Hemophilus influenza B vaccine [Hib-MenCY], 4 dose schedule, when administered to children 2-15 months of age, for intramuscular use) has been approved by the FDA. This means that this code can be used without the “lightning bolt” signifying its “approval pending” status.

Other Important Changes

• The influenza vaccine codes 90655-90660 will now include the term “trivalent” in their descriptors. The term is used to signify that the vaccine comprises three influenza viruses, with all three components incorporated in one vaccination.
• CPT 2013 will have these new codes included:
• 90653 (Influenza virus vaccine, inactivated, subunit, adjuvanted, for intramuscular use)
• 90672 (Influenza virus vaccine, quadrivalent, live, for intranasal use)

Though released on July 1, these codes will be implemented only on January 1, 2013.

New Code for Hepatitis Vaccine

CPT® 2013 will have a new code to represent Hepatitis B vaccination. This is Code 90739 (Hepatitis B vaccine, adult dosage [2 dose schedule], for intramuscular use), which will go into effect from January 1 onwards. CPT® will also revise the Hepatitis B vaccine code 90746 to include the identifier “3-dose schedule”.