|Billing Influenza Vaccines after January 1|
Beginning with dates of service on and after January, 1, 2011, the Centers for Medicare & Medicaid Services (CMS) no longer accepts influenza CPT®* code90658 (Influenza virus vaccine . . . when administered to individuals 3 years and older, for intramuscular use).
Instead, when billing for a patient covered by Medicare or MedicareBlueSM PPO, use the following HCPCS codes:
HCPCS Short Description
Q2035 Afluria vaccine, 3 yrs & older, intramuscular
Q2036 FluLaval vaccine, 3 yrs & older, intramuscular
Q2037 Fluvirin vaccine, 3 yrs & older, intramuscular
Q2038 Fluzone vaccine, 3 yrs & older, intramuscular
Q2039 NOS flu vaccine, 3 yrs & older, intramuscular
If billing services for a Wellmark member:
- use CPT code 90658 instead of HCPCS code Q2039; Wellmark does not accept Q2039.
- use a specific CPT code, or HCPCS code Q2035, Q2036, Q2037, or Q2038 as appropriate..
*CPT® is a trademark of the American Medical Association. Current Procedural Terminology © 2011 American Medical Association. All Rights Reserved.