Find Your Way Through Flu Vax Coding with These Updates
Stay informed on 2023-2024 flu vaccine codes, compositions, allergy updates, and administration guidelines to streamline your practice’s flu season protocols and coding.
Pediatric Billing & Coding Alert
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Flu season is officially here, bringing with it updates on vaccines, codes, and new recommendations. This year, healthcare providers can select from as many as nine different flu vaccines. Regardless of how many vaccines your practice administers in the upcoming months, it's crucial to stay up-to-date on flu vaccine protocols.
Here’s everything you need to know about the latest codes, guidelines, and recommendations to navigate the flu season with ease.
Key Updates on Flu Vaccine Compositions
For the 2023-2024 flu season, all vaccines will continue to be quadrivalent (four-component), as has been the case in recent years. In line with previous seasons, 91% of the vaccines will be thimerosal-free or thimerosal-reduced, and approximately 21% of flu vaccines will be egg-free.
Updated Recommendations for Egg Allergy and Flu Vaccination
In previous flu seasons, the Advisory Committee on Immunization Practices (ACIP) advised that individuals with severe egg allergies receive their vaccinations in a medical setting. However, for the 2023-2024 flu season, the ACIP no longer recommends additional safety measures for those with egg allergies, regardless of the severity of their previous reactions. This means anyone with a history of egg allergy—regardless of severity—can safely receive any flu vaccine that is suitable for their age and health.
“This update will be a welcome change for clinicians who have had to manage separate vaccine supplies for allergic patients.”
“The effort and costs associated with inventory tracking and reconciliation are not well-compensated. Every bit of time saved in providing essential preventive care is beneficial.”
Important Flu Vaccine Codes to Avoid Reporting Incorrectly
Pediatricians, who do not typically treat patients aged 65 and older, should be cautious not to report the following codes incorrectly:
- Fluzone High-Dose Quadrivalent 0.7 mL pre-filled syringe: This should be reported using 90662 (Influenza virus vaccine (IIV), split virus, preservative-free, enhanced immunogenicity via increased antigen content, for intramuscular use).
- Fluad Quadrivalent 0.5 mL pre-filled syringe: This should be reported using 90694 (Influenza virus vaccine, quadrivalent (aIIV4), inactivated, adjuvanted, preservative-free, 0.5 mL dosage, for intramuscular use).
Additionally, the following code is for a vaccine intended for patients over 18 years old:
- Flublok Quadrivalent 0.5 mL pre-filled syringe: This should be reported using 90682 (Influenza virus vaccine, quadrivalent (RIV4), derived from recombinant DNA, hemagglutinin (HA) protein only, preservative and antibiotic-free, for intramuscular use).
Notice the Discontinuation of 0.25 mL Pre-Filled Fluzone
Fluzone Quadrivalent, which was previously available for children aged 6-35 months in both 0.25 mL and 0.5 mL doses, is no longer offered in the 0.25 mL pre-filled syringe. For children in this age group who receive the 0.5 mL dose from the pre-filled syringe, you will now need to code 90686 (Influenza virus vaccine, quadrivalent (IIV4), split virus, preservative-free, 0.5 mL dosage, for intramuscular use).
COVID-19 and Flu Vaccine Guidance
The ACIP states that inactivated and recombinant influenza vaccines can be administered either concurrently or sequentially with other live or inactivated vaccines. This means that the live attenuated flu vaccine can be given at the same time as other live or inactivated vaccines. However, if two live vaccines are not administered together, there should be at least a four-week gap between the live attenuated flu vaccine and another live vaccine.
Additionally, the ACIP recommends deferring flu vaccination for patients who are moderately or severely ill until they have recovered. Clinicians can use their discretion regarding patients with mild COVID-19 symptoms or who are asymptomatic.
Note: As of Nov. 1, 2023, CPT® simplified COVID vaccine coding by consolidating over 50 immunization codes. When reporting both flu and COVID vaccines in the same encounter, be sure to use the updated code set for the COVID vaccine.
Don't Forget to Include Administration Codes
When reporting flu vaccinations, it's important to include an appropriate immunization administration code. Choose from the following options based on the method of administration:
- 90460: Immunization administration for individuals up to 18 years of age, with counseling by a physician or other qualified healthcare professional.
- 90471: Immunization administration for percutaneous, intradermal, subcutaneous, or intramuscular injections.
- 90473: Immunization administration for intranasal or oral route vaccinations.
Make sure to use the correct code that corresponds with the specific vaccination method.
BillingFreedom, Your Trusted Medical Billing Experts in Comprehensive Vaccine Billing
BillingFreedom excels in precise and efficient pediatric medical billing services for flu and COVID-19 vaccinations, ensuring seamless compliance with the latest coding guidelines. Our team is proficient in navigating the complexities of vaccine administration codes, from quadrivalent flu vaccines to updated COVID-19 immunization coding. We’re knowledgeable in specific codes, such as 90686 for pediatric flu doses, and stay up-to-date with the Advisory Committee on Immunization Practices (ACIP) recommendations, including egg allergy guidance and concurrent vaccine administration.
By choosing BillingFreedom, you partner with a billing team that reduces billing errors, improves reimbursement timelines, and ensures accurate code application so your practice can focus on providing top-quality patient care.
Trust us to handle all your vaccine billing needs with precision and expertise.
For more details about our exceptional medical billing services, please don't hesitate to email us at info@billingfreedom.com or call us at +1 (855) 415-3472.
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