How to Code H1N1 Vaccinations ?

Mon, Jan 19, 2015 --

Reader Questions

You’ll report H1N1 as a regular flu virus.

Influenza is a hot topic this season. According to Centers for Disease Control and Prevention (CDC), flu activity is expected to continue in the coming weeks. Don’t be surprised if your practice witnesses an increase in queries for H1N1 vaccinations in the coming days. You may have various questions such as:

  •  What are the coding choices for reporting H1N1 vaccination – and restrictions if any?
  •  Is it a pandemic?
  •  Can you submit codes for both type of vaccine and administration of vaccine?

H1N1

Here are some helpful notes on how you should report H1N1 vaccination:

About H1N1: H1N1 flu, also called swine flu, is a respiratory infection caused by an influenza virus. As the name suggests, the flu shot is not spread from pigs — instead it spreads from person to person. According to CDC, the H1N1 virus that caused the pandemic is now a regular human flu virus.

You will report the codes that you use to report most types of flu injections:

  • For the particular vaccine you use, report from within 90654-90688.
  • For Medicare beneficiaries, use from within Q2033-Q2039.

For the administration of the injection, look to these choices:

  • For single injection, use 90471
  •  For subsequent injections, use 90472
  • For single intranasal or intraoral application, use 90474
  • For additional intranasal or intraoral applications, use for additional intranasal or intraoral applications

For Medicare-only patients, use administration code G0008.

Diagnosis: Use V04.81 as your diagnosis. Medicare has fixed the payment at same rates as the administration of the seasonal influenza vaccine.

barnalig@eliresearch.com'

About 

Barnali Gogoi is a medical coding and billing writer with over 7 years of experience in the industry. She holds a Masters Degree in English Literature from Gauhati University and a diploma in advertising and marketing from YMCA.

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