It’s Flu Season!
The 2020 – 2021 flu season is here and with COVID-19 still circulating, it’s more important than ever to get a flu vaccine. Since both the flu and COVID-19 have some similar symptoms, the Center for Disease Control and Prevention recommends that all persons 6 months and older receive a flu vaccine. Some important similarities and differences to recognize are:
• Fever
• Chills
• Body Aches
• Runny Nose
• Sore Throat
• Cough
One symptom that seems to be more COVID-19 specific is sudden loss of taste or smell. Infections disease specialist Peter Chin-Hong notes that some symptoms that are less likely to be COVID-19 related are runny nose, watery eyes or diarrhea. He also added that children under 10 are less likely to be infected with or show symptoms of COVID-19, so if flu-like symptoms are present, they are more likely to have the flu.
Coding and Reimbursement
The Medicare Part B payment allowance* for flu vaccines are 95% of the Average Wholesale Price except when the vaccine is administered in a hospital outpatient department, Rural Health Clinic or Federally Qualified Health Center. When the vaccine is furnished in these specific settings, payment for the vaccine is based on reasonable cost. The annual Medicare Part B deductible and coinsurance amounts do not apply for the flu vaccination. Any physician, non-physician practitioner or other suppliers who administer these vaccinations must accept assignment on the claim, according to the Centers for Medicare & Medicaid Services.
The following HCPCS/CPT Codes are for the 2020-2021 flu season:
Administration & Diagnosis Codes Vaccine Codes & Descriptors
90656 Influenza virus vaccine, trivalent (IIV3), split virus, preservative free, 0.5 mL dosage, for intramuscular use
90657 Influenza virus vaccine, trivalent (IIV3), split virus, 0.25 mL dosage, for intramuscular use
90658 Influenza virus vaccine, trivalent (IIV3), split virus, 0.5 mL dosage, for intramuscular use
90660 Influenza virus vaccine, trivalent, live (LAIV3), for intranasal use
90662 Influenza virus vaccine (IIV), split virus, preservative free, enhanced immunogenicity via increased antigen content, for intramuscular use
90682 Influenza virus vaccine, quadrivalent (RIV4), derived from recombinant DNA, hemagglutinin (HA) protein only, preservative and antibiotic free, for intramuscular use
90685 Influenza virus vaccine, quadrivalent (IIV4), split virus, preservative free, 0.25 mL dosage, for intramuscular use
90686 Influenza virus vaccine, quadrivalent (IIV4), split virus, preservative free, 0.5 mL dosage, for intramuscular use
90688 Influenza virus vaccine, quadrivalent (IIV4), split virus, 0.5 mL dosage, for intramuscular use
G0008 Administration of influenza virus vaccine
*For a full list of Influenza Vaccine Pricing for the 2020-2021 Season, click here
**Information from CMS.gov. For full list of HCPCS/CPT Codes, click here
New Combined Laboratory Tests Are Available
Diagnostic Multiplex Assay for Flu & COVID-19
The CDC Multiplex Assay (Flu SC2) is a test that detects and differentiates RNA from the COVID-19 virus, the influenza A virus and the influenza B virus in upper or lower respiratory specimens. The U.S. Food and Drug Administration granted emergency authorization for this test in July 2020. Some benefits of this test include:
• Serves as a single test to diagnose which of three viruses
• Allows laboratories to process more tests in a given timeframe
• Allows public health officials in their task of controlling the spread of the flu and COVID-19
• Allows for ongoing flu surveillance while also testing for COVID-19
• Conserves testing materials that may be in short supply
• Other benefits can be found by visiting cdc.gov/coronavirus
Pixel by LabCorp
In September, LabCorp announced the launch of a testing method that will detect COVID-19, Influenza A/B and RSV. This since panel test can help physicians to diagnose patients and make decisions on treatment options. It is available through doctors, hospitals and other authorized healthcare providers nationwide. This at-home test includes:
• 1 saline collection tube
• 1 foam swab
• 1 biohazard specimen bag
• 1 Pixel box
• FedEx return pack
• Instructions for use
The American Medical Association’s New Codes for Multi-Virus Testing
Two new codes have been approved for immediate use by the AMA that allow for a single test to simultaneously detect COVID-19 and Influenza A/B.
• 87636 – Infectious agent detection by nucleic acid (DNA or RNA); severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (Coronavirus disease [COVID-19]) and influenza virus types A and B, multiplex amplified probe technique.
• 87637 – Infectious agent detection by nucleic acid (DNA or RNA); severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (Coronavirus disease [COVID-19]), influenza virus types A and B, and respiratory syncytial virus, multiplex amplified probe technique.
About PGM
Physicians Group Management (PGM) is one of the fastest-growing medical billing companies in the United States. For over 35 years, PGM has been providing medical billing and practice management services and software to physicians, healthcare facilities, and laboratories. PGM’s current client base encompasses the full spectrum of medical specialties, including Internal Medicine, Dermatology, Plastic & Reconstructive Surgery, Pathology, EMS & Ambulatory Services, Cardiology, Nephrology, Urology, Pain Management, OB/GYN, Gastroenterology, Independent Laboratory, and many more. PGM’s medical billing and practice management solutions include:
– A full suite of practice management and medical billing solutions each tailored to the specific needs of your practice
– CCHIT-certified electronic medical record software and services
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– Practice management software that provides advanced financial and practice analysis tools, specifically designed to give enhanced visibility of operations at the click of a button
– Laboratory billing software that offers best-in-class systems to streamline, and manage and track, financial and administrative processes