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CPT Codes for H1N1 Vaccine Now in Effect


 

The American Medical Association has created a new Current Procedural Terminology code (90470) and revised an existing code (90663) for use with H1N1 vaccinations, according to a statement issued by the association.

The new and revised CPT codes will help streamline vaccination reporting and reimbursement as physicians prepare to administer nearly 200 million doses of the new H1N1 vaccine this fall, the AMA said in the statement.

The details of the codes are as follows:

▸ 90470: H1N1 immunization, both intramuscular and intranasal, including counseling.

▸ 90663: Influenza virus vaccine (pandemic H1N1 formulation).

Both the new Category I CPT Code 90470 and the revised code 90663 are effective immediately. Code 90470 was created for use when reporting H1N1 vaccination and counseling, while code 90663 was revised to include the specific H1N1 vaccine product, according to the statement. To be paid for H1N1 vaccine administration, providers should bill 90663 in conjunction with 90470, the AMA said.

The 90663 code should be billed at zero dollars, because the vaccine itself is being provided by the federal government at no charge. Providers will be paid for vaccine administration, the AMA said.

The codes were created in a joint effort by the AMA CPT editorial panel and the U.S. Department of Health and Human Services.

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