FLUZONE , INFLUENZA VACCINE CODING AND BILLING …

FLUZONE?, INFLUENZA VACCINE CODING AND BILLING CHECKLIST

Are you ready? Are you sure that your systems are fully updated? Are you aware of important influenza vaccination payment timelines and processes?

? Make sure you're ready by viewing Sanofi Pasteur's complimentary webinar, "Cracking the Codes: Coding and Billing for Vaccination with Fluzone, Influenza Vaccines." This program provides detailed information on coding and billing for Fluzone vaccinations.

? Register for a session with a live Q&A opportunity or view the program "on-demand" at your convenience ? Download the helpful resources available with this program including state-specific Medicaid coding rules. ? A sk your Sanofi Pasteur representative or watch for emails from ? for information on

how to register. Registration is expected to open in early June for program availability beginning in July.

? Make sure your systems are updated to include the CPT?a codes for the Fluzone vaccines you are using.

Vaccine Fluzone High-Dose Fluzone Intradermal Quadrivalent Fluzone Quadrivalent Fluzone Quadrivalent Fluzone Quadrivalent Fluzone Quadrivalent

Presentation

CPT

0.5-mL dose syringe

90662

0.1-mL dose microinjection system 90630

0.25-mL syringe 0.5-mL syringe 0.5-mL vial 5-mL vial

90685 90686 90686 90687 (0.25 mL) 90688 (0.5 mL)

? Review the codes to use when billing for administering Fluzone vaccines.

Patients 0-18 Years of Age Patients 0-18 Years of Age Patients 19 Years of Age and Older,

With Qualified Counseling Without Qualified Counseling With or Without Qualified Couseling

90460

90471 or 90472

90471 or 90472

G0008 (Medicare)

G0008 (Medicare)

? Do any of your payers require NDC codes? Do they prefer the carton or unit-of-use NDC? Update your systems to include the correct 2016-2017 NDCs. ? Be sure to code using an 11-digit NDC. For Fluzone vaccines, add a "0" at the start of the middle set of digits. For example: 49281-399-65 = 49281-0399-65

Vaccine Fluzone High-Dose Fluzone Intradermal Quadrivalent Fluzone Quadrivalent Fluzone Quadrivalent Fluzone Quadrivalent Fluzone Quadrivalent

Presentation 0.5-mL syringe 0.1-mL dose microinjection system 0.25-mL syringe 0.5-mL syringe 0.5-mL vial 5-mL vial

Pkg NDC 49281-0399-65 49281-0710-40

Unit NDC 49281-0399-88 49281-0710-48

49281-0516-25 49281-0416-50 49281-0416-10 49281-0625-15

49281-0516-00 49281-0416-88 49281-0416-58 49281-0625-78

Note: These products are for the 2016-2017 influenza season and are not yet licensed as of May 16, 2016.

? Be sure to attach ICD-10 code, Z23, to the Fluzone vaccine code and the administration code. ? Z23 = Encounter for immunization

? When a Fluzone vaccine is administered on the same date as an Evaluation and Management (E/M) visit, consider attaching modifier -25 to the E/M code. ? A pply modifier -25 to the E/M CPT code to communicate that the E/M visit was a "significant and separately identifiable" service from the vaccine and vaccine administration service.

? If you are a facility provider and revenue codes are required, make sure you are using the correct codes for influenza vaccination. ? Revenue code 0636, `prescription drugs that require detailed coding' is used with the vaccine code. ? Revenue code 0771, `preventative care services vaccine administration' is used with the vaccine administration code.

? Medicare updates their fee schedule annually on October 1, retroactive to August 1. For dates of service prior to October 1, you can hold your claims and then bill to receive the updated payment, or you can choose to bill prior to October 1 and have your payments adjusted later. ? Some regional Medicare Administrative Contractors (MACs) automatically make payment adjustments after October 1. ? Other MACs require action on the part of the provider in order for a payment adjustment to be made. ? Y our Sanofi Pasteur representative or our complimentary Reimbursement Support Service can advise you on your regional MAC's policy.

? Remember to use the complimentary Sanofi Pasteur Reimbursement Support Service (RSS). ? The service can assist you with coding, coverage, payment, and patient eligibility ? Most payers update their flu payments between July and October; the RSS can provide updated payment information as soon as it is available. ? The RSS can help you with Medicare payment updates, policy, and timelines.

? Visit the Reimbursement section of for additional resources. ? Find many product specific tools and resources for all Sanofi Pasteur products.

Ask your Sanofi Pasteur representative for coding tools and resources to help support your practice. We have resources that provide more in-depth information on the topics within this checklist. If you want more information, just ask for it ? we are happy to help!

a CPT (Current Procedural Terminology) is a registered trademark of the American Medical Association. b HCPCS = Healthcare Common Procedure Coding System.

SANOFIPASTEUR. DiscoveryDrive. Swiftwater, Pennsylvania 18370. sanofipasteur.us

MKT30979-1

? 2016 Sanofi Pasteur Inc.

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