Coding: Annual Coding Changes
New as of November 10, 2010! Coding for H1N1 vaccine
The AMA has come out with a new CPT code for the administration of the H1N1 vaccine, 90470, and revised existing code 90663 to include the H1N1 vaccine itself. CMS has also created HCPCS codes for the administration of the H1N1 vaccine, G19141, and for the vaccine itself, G9142. The vaccine is provided free of charge by the federal government so physicians will not be reimbursed for the vaccine product, only the administration. There is discrepancy between payers about which code set to use and the appropriate dollar amount to be listed for the vaccine. Some payers and billing systems may not be able to accommodate a zero dollar charge.
TNAAP has collected the most recent guidelines for reporting each code set: H1N1 Coding Update, November 10, 2010 (PDF).
The American of Academy of Pediatrics (AAP) has sent a letter to major carriers urging them to pay no less than current Medicare rates for the administration. You can access that letter at www.aap.org/moc/reimburse/privatesector.htm.
Annual Coding Changes
The following is a list of annual coding updates of most interest to pediatricians and family practitioners. ICD-9 coding updates are effective beginning October 1st of each year. The CPT coding updates are effective beginning on January 1st of each year. Please see the latest version of the ICD-9 or CPT coding manuals for a complete list of annual code changes.
2010 ICD-9-CM Pediatric Coding Updates - Additions, Revisions, Deletions, October 1, 2009
2009 Pediatic ICD-9-CM Coding Updates - Additions, Revisions, Deletions, Oct. 1, 2008
