MCARE REIMBURSEMENT FOR FLUZONE HIGH-DOSE

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We are going to be giving the Fluzone High-Dose Flu Vaccine for our pt's 65 and over and I have been asked if there is a different CPT code to bill Mcare pt's to what we used last year, Q2036, Has anyone seen anything from Mcare on this or not.


Please and thanks, any help or suggestions would be helpful


Rosemary Hoormann,CPC





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We are going to be giving the Fluzone High-Dose Flu Vaccine for our pt's 65 and over and I have been asked if there is a different CPT code to bill Mcare pt's to what we used last year, Q2036,  Has anyone seen anything from Mcare on this or not.




Please and thanks, any help or suggestions would be helpful





Rosemary Hoormann,CPC









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Comments

  • Hi there,

    Fluzone Hi-Dose CPT is 90662.
    http://www.fluzone.com/health-care-professionals/fluzone-coding-reimbursement.cfm




    Kind Regards,

    Patricia Koenig-Claybaugh
    RHIT CPC CPMA CCA
    Internal Clinical Documentation Analyst
    Internal Quality Review Education
    Health First Medical Group
    378 North Babcock Street
    Melbourne FL 32935
    321.725.4500 ext.4863
    321.725.1822 fax
    patricia.koenig-claybaugh@health-first.org
    >>> 9/21/2016 2:51 PM >>>
    We are going to be giving the Fluzone High-Dose Flu Vaccine for our pt's 65 and over and I have been asked if there is a different CPT code to bill Mcare pt's to what we used last year, Q2036, Has anyone seen anything from Mcare on this or not.


    Please and thanks, any help or suggestions would be helpful

    Rosemary Hoormann,CPC






  • This week in Medicare updates–09/21/2016

    Seasonal Influenza Vaccines Pricing
    The Medicare Part B payment allowance limits for seasonal influenza and pneumococcal vaccines are 95% of the Average Wholesale Price (AWP) as reflected in the published compendia except where the vaccine is furnished in a hospital outpatient department. When the vaccine is furnished in the hospital outpatient department, payment for the vaccine is based on reasonable cost.
    Annual Part B deductible and coinsurance amounts do not apply for the influenza virus and the pneumococcal vaccinations. All physicians, non-physician practitioners, and suppliers who administer these vaccinations must take assignment on the claim for the vaccine.
    In 2012, to better conform to the Center for Disease Control and Prevention’s (CDC) recommendations for the prevention and control of influenza, CMS changed the payment limit effective date from September 1 to August 1. Recent CDC recommendations state that vaccination efforts should begin as soon as the seasonal influenza vaccine is available and continue through the influenza season. Please see Transmittal 2424 in the Downloads section for more information.
    Payment Allowances and Effective Dates for the 2016-2017 Flu Season:
    · CPT 90630 Payment allowance is $20.343. Effective dates: 8/1/2016-7/31/2017
    · CPT 90653 Payment allowance is $37.383. Effective dates: 8/1/2016-7/31/2017
    · CPT 90656 Payment allowance is $17.717. Effective dates: 8/1/2016-7/31/2017
    · CPT 90657 Payment allowance is pending. Effective dates: 8/1/2016-7/31/2017
    · CPT 90661 Payment allowance is pending. Effective dates: 8/1/2016-7/31/2017
    · CPT 90662 Payment allowance is $42.722. Effective dates: 8/1/2016-7/31/2017
    · CPT 90672 Payment allowance is $26.876. Effective dates: 8/1/2016-7/31/2017
    · CPT 90673 Payment allowance is $40.613 Effective dates: 8/1/2016-7/31/2017
    · CPT 90674 Payment allowance is $22.936 Effective dates: 8/1/2016-7/31/2017
    · CPT 90685 Payment allowance is $26.268. Effective dates: 8/1/2016-7/31/2017
    · CPT 90686 Payment allowance is $19.032. Effective dates: 8/1/2016-7/31/2017
    · CPT 90687 Payment allowance is $9.403. Effective dates: 8/1/2016-7/31/2017
    · CPT 90688 Payment allowance is $17.835. Effective dates: 8/1/2016-7/31/2017
    · HCPCS Q2035 Payment allowance is $16.284. Effective dates: 8/1/2016-7/31/2017
    · HCPCS Q2037 Payment allowance is $16.284. Effective dates: 8/1/2016-7/31/2017
    · HCPCS Q2039 Flu Vaccine Adult - Not Otherwise Classified payment allowance is to be determined by the local claims processing contractor with effective dates of 8/1/2016-7/31/2017.
    Additional information on 2016-2017 Influenza Vaccines pricing is available in MM9758, which is available in the 'Downloads' section below. Information for some codes is pending FDA approval. Updates to the payment limits and effective dates will be posted to this webpage.


    Mindy L Dowd CPC,CPMA
    Denver Arthritis Clinic
    200 Spruce St
    Suite 100
    Denver,CO 80230
    (303)302-7433
    mdowd@dacdenver.com

    From: hoormannradar@aol.com [mailto:hoormannradar@aol.com]
    Sent: Wednesday, September 21, 2016 12:52 PM
    To: Multiple recipients of list PARTB-L
    Subject: [partb-l] MCARE REIMBURSEMENT FOR FLUZONE HIGH-DOSE

    We are going to be giving the Fluzone High-Dose Flu Vaccine for our pt's 65 and over and I have been asked if there is a different CPT code to bill Mcare pt's to what we used last year, Q2036, Has anyone seen anything from Mcare on this or not.

    Please and thanks, any help or suggestions would be helpful

    Rosemary Hoormann,CPC











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