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Coding Guidance:
ICD-9 Code for Influenza Immunization:
V04.81, Prophylactic vaccination and inoculation against influenza.
Each vaccine/toxoid product administered must be coupled with an administration code.
Providers need to be aware of each Payer's policies regarding coding to receive proper reimbursement.
Many third party payers require Current Procedural Terminology (CPT) administration codes 90471-90474 to report administration of vaccine products.
Medicare and other third party payers require Healthcare Common Procedure Coding System (HCPCS) code G0008 to report administration of influenza vaccine.
CPT®* codes for influenza immunization
For the 2005-2006 influenza immunization season, the National Drug Code (NDC) numbers and product descriptions that fall under each CPT code are:
CPT®* Code |
CPT Description |
Manufacturer
Brand |
NDC # |
Presentation |
90655 |
Influenza virus vaccine, split virus, preservative free, for children 6-35 months of age, for intramuscular use |
Aventis Pasteur
Fluzone®, Influenza Virus Vaccine, No Preservative: Pediatric Dose ± |
49281-0005-25 |
10 single-dose syringes |
90656 |
Influenza virus vaccine, split virus, preservative free, for use in individuals 3 years of age and above, for intramuscular use |
Aventis Pasteur
Fluzone®, Influenza Virus Vaccine, No Preservative ± |
49281-0005-50
49281-0005-10 |
10 single-dose syringes
10 single-dose vials |
Chiron Vaccines
Fluvirin®, Influenza Virus Vaccine§ |
66521-0108-01 |
10 single-dose syringes |
90657 |
Influenza virus vaccine, split virus, for children 6-35 months of age, for intramuscular use |
Aventis Pasteur
Fluzone®, Influenza Virus Vaccine± |
49281-0376-15 |
5 mL vial |
90658 |
Influenza virus vaccine, split virus, for use in individuals 3 years of age and above, for intramuscular use |
Aventis Pasteur
Fluzone®, Influenza Virus Vaccine± |
49281-0376-15 |
5 mL vial |
Chiron Vaccines
Fluvirin®, Influenza Virus Vaccine§ |
66521-0108-10 |
5 mL vial |
90660 |
Influenza virus vaccine, live, for intranasal use |
MedImmune Vaccines, Inc
FluMist® , Live Influenza Virus Vaccine.¥ |
66019-0103-01 |
10 prefilled, single-use sprayers |
*CPT is a registered trademark of the American Medical Association.
†Indicated for persons 6 months of age and older.
§Indicated for persons 4 years of age and older.
||Indicated for healthy persons 5-49 years of age.
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