Get ready to change your flu vaccine product code 90658 to one of four Q codes.
For 2010, report 90658 (Influenza virus vaccine, split virus, when administered to individuals 3 years of age and older, for intramuscular use) to signify that your physician administered a vaccine with preservatives to a patient over the age of three. Medicare will no longer pay for claims with 90658 “effective for claims with dates of service on or after Jan. 1, 2011,” according to MLN Matters article MM7234.
Instead, you’ll have to bill based on the specific brand-name flu vaccine that the physician administers using the following new HCPCS level II codes:
- Q2035 – Influenza virus vaccine, split virus, when administered to individuals 3 years of age and older, for intramuscular use; Afluria
- Q2036 – Flulaval
- Q2037 – Fluvirin
- Q2038 – Fluzone
- Q2039 – Not otherwise specified.
Important: Don’t start submitting the new codes just yet. The Q codes are in effect as of Oct. 1 but Medicare claims processing systems may need until Feb. 7, 2011 to process the new codes. If you vaccinate a Medicare patient before the end of this year, bill using 90658. After Jan. 1, hold claims until your carrier’s system can accept the new codes.
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