Prepping for the 2018-2019 Flu Season

October 23, 2018

Flu season is upon us and we want to give you immunization updates to help you give your patients and our members the best possible care.

The Centers for Disease Control and Prevention (CDC) recommends yearly flu shots for all patients ages six months and older without contraindications during the 2018-2019 influenza season. Clinicians may administer any licensed, age-appropriate flu shot. The prefilled intranasal sprayer flu vaccine, which was not recommended the past two flu seasons, is now recommended for this season. Please remember, it’s vital to review the “Table of Approved Vaccines on the CDC website for the most recent updates on newly available products and the approved age ranges.

For 2018-2019, there is a new flu vaccine, pending FDA approval. The vaccine is preservative-free Fluad Quadrivalent Pediatric® with adjuvant MF59,C2 for people six to 23 months of age. The Current Procedural Terminology (CPT) code is 90689 for claims processed with dates of service (DOS) on or after Jan. 1, 2019. Before Jan. 1, 2019, claims may be submitted with 90749-Unlisted vaccine/toxoid or Q2039-Influenza virus vaccine, not otherwise specified.

Also, please file your claims with the accurate coding. The coding chart from the American Academy of Pediatrics (AAP) names which billing code to use based on the vaccine administered (this chart is not a comprehensive list). When billing flu vaccines, please note code descriptions contain descriptions specific to vaccine products such as dosage, formulations such as trivalent vs. quadrivalent, preservative vs. preservative free, or other distinctive features (i.e. split virus, recombinant DNA, cell cultures, or adjuvanted).

Details on our complete, approved immunization schedule can be found on the BCBSNM Provider page under Standards & Requirements, Clinical Payment and Coding Policies, “reventive Services Policy CPCP006 PDF Document.”