Dear Members,
Please be advised that CMS has updated Medicare's Common Working File (CWF) and fiscal intermediary system with a new flu vaccine code, 90689.
CMS has updated their
Medicare Claims Processing Manual to reflect this change, stating:
"Effective for claims processed with Dates of Service (DOS) on or after January 1, 2019,influenza virus vaccine code 90689 (Influenza virus vaccine quadrivalent (IIV4), inactivated, adjuvanted,preservative free, 0.25mL dosage, for intramuscular use) will be payable by Medicare. This new code willbe included on the 2019 Medicare Physician Fee Schedule Database file update and the annual HealthcareCommon Procedure Coding System (HCPCS) update.
Contractors shall use the Centers for Medicare & Medicaid Services (CMS) Seasonal Influenza VaccinesPricing webpage to obtain the payment rate for influenza virus code 90689. The new influenza virus vaccinecode 90689 is not retroactive to August 1, 2018. No claims should be accepted for influenza virus vaccinecode 90689 between the DOS August 1, 2018 and December 31, 2018. If claims are received in January2019 with code 90689 for DOS between August 1, 2018 and December 31, 2018, contractors should followtheir normal course of action for codes billed prior to their effective date."
Medicare Learning Network (MLN) Matters Article
MM 10871, Quarterly Influenza Virus Vaccine Code Update - January 2019 was revised to reflect this change. Please share with your billing staff as needed.
Thank you!