Prepping for the 2018-2019 Flu Season

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Prepping for the 2018-2019 Flu Season

September 4, 2018

Updated October 3, 2018 to add Fluad Quadrivalent Pediatric is still pending final FDA approval

Flu season is upon us and Blue Cross and Blue Shield of Texas (BCBSTX) wants to provide you with immunization updates to give your patients and our members the best possible care.

The Centers for Disease Control and Prevention (CDC) recommends yearly flu shots for all patients ages six months and older without contraindications during the 2018-2019 influenza season. Clinicians may administer any licensed, age-appropriate flu shot. The prefilled intranasal sprayer flu vaccine, which was not recommended the past two flu seasons, is now recommended for this season. Please remember, it’s vital to review the “Table of Approved Vaccines” on the CDC website for the most recent updates on newly available products and the approved age ranges.

For 2018-2019, there is a new preservative-free flu vaccine (pending FDA approval), Fluad Quadrivalent Pediatric^® with adjuvant MF59, for children 6 to 23 months of age. The Current Procedural Terminology (CPT^®) code is 90689 for claims processed with dates of service on or after Jan. 1, 2019. Before Jan. 1, 2019, claims may be submitted with 90749-Unlisted vaccine/toxoid or Q2039-Influenza virus vaccine, not otherwise specified.

Also, please file your claims with the accurate coding. The coding chart from the American Academy of Pediatrics (AAP) indicates which billing code to use based on the vaccine administered (this chart is not a comprehensive list). When billing flu vaccines, please note code descriptions may contain specifics to vaccine products such as dosage, formulations (such as trivalent vs. quadrivalent), preservative vs. preservative-free, or other distinctive features (i.e. split virus, recombinant DNA, cell cultures, or adjuvanted).

Details on our complete approved immunization schedule can be found on the BCBSTX provider website under Standards & Requirements, Clinical Payment and Coding Policies, “ Preventive Services Policy CPCP006” PDF Document .