Confused About Flu Shots?

During flu season, flu shots are common in the medical billing world. Like everything else, there are many different flu current procedural terminology codes from which to choose. There are three steps to follow to ensure your flu shot medical billing is completely accurate.

The first step is to figure in the age of the patient. Any patient who is age three and above should be given one of two medical billing codes: 90656 or 90658. The medical billing code 90656 stands for: influenza virus vaccine, split, virus, preservative-free, for use in individuals 3 years of age and above, for intramuscularly use. The code 90658 in medical billing means: Influenza virus vaccine, split virus, for use in individuals 3 years of age and above, for intramuscularly use. Any patient below three years of age, the code 90655 or 90657 should be used in medical billing.

The next medical billing step for choosing the correct flu shot code is to determine if the flu vaccination is preservative-free or not. As you can see in the definitions of the medical billing codes 90656 and 90658, they are the same except one has preservatives while the other does not. This is quite simple to check because the package clearly states if it has preservatives or not.

The third step in flu shot medical billing is to rule out intranasal vaccinations. The only code that is ever used for an intranasal vaccination is CPT 90660 (Influenza virus vaccine, live, for intranasal use). The Flumist is an intranasal vaccination.

By following these simple steps, flu shot medical billing is extremely simple. As long as you read the definitions of the CPT codes, and match the service to the definition, you will be fine.

View all Articles by: Kathryn E, CCS-P - Retired