The Centers for Medicare & Medicaid Services (CMS) is changing the payment status indicator for CPT® code 90662 Influenza virus vaccine, split virus, preservative free, enhanced immunogenicity via increased antigen content, for intramuscular use from “E” (not paid under the Outpatient Prospective Payment System (OPPS)) to “L” (not paid under OPPS; paid at reasonable cost; not subject to deductible or co-insurance) in the October 2010 Integrated Outpatient Code Editor (IOCE).

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The Centers for Disease Control and Prevention’s (CDC’s) National Center for Health Statistics (NCHS) posted updates Aug. 5 to the ICD-9-CM Official Guidelines for Coding and Reporting. These guidelines for diagnosis coding are effective Oct. 1.

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The U.S. Centers for Disease Control and Prevention (CDC) reviewed/updated July 1 the CDC Vaccine Price Lists, which provide current contract and private sector vaccine prices. Contract prices are for CDC vaccine contracts that are established for the purchase of vaccines by immunization programs receiving CDC immunization grant funds (i.e., state health departments, certain large city immunization projects, and certain current and former U.S. territories).

As of May 14, the CDC vaccine price list also shows the National Drug Code (NDC) code and contract number for each vaccine.

The CDC Vaccine Price Lists are available on the CDC website.

The CDC also updated on June 24 the Immunization Program Operations Manual with new chapters and updated on June 16 the hepatitis A and B vaccines supply list. Of note:

“Merck’s adult and dialysis formulations of their hepatitis B vaccine (Recombivax HB®) currently are not available. The adult formulation will not be available during the remainder of 2010; the dialysis formulation is expected to become available in Q3 of 2010. Production and supply of GSK’s adult hepatitis B vaccine (Adult Engerix-B®) and Adult hepatitis A/hepatitis B combination vaccine (Twinrix®) currently are sufficient to meet demand for routine adult usage of this vaccine as well as CDC’s ongoing High Risk Adult Hepatitis B Initiative.”

The adult formulation of hepatitis A vaccine (VAQTA®) from Merck also will not be available in 2010. “GSK is currently out of stock on both presentations (syringe and vial) of its adult hepatitis A vaccine (though some distributors may still have product available) but anticipates that sufficient supply of at least one presentation will be available to meet demand for routine adult usage of this product by the end of June. In addition, GSK’s adult hepatitis A/ hepatitis B combination vaccine (Twinrix®) currently is available as an alternative product.”

Health care professionals may also be interested in a self-study education program called “Adult Immunization 2010” now available courtesy of the CDC.

Physicians will soon have a new test they can use to diagnose patients with the 2009 H1N1 influenza virus. Developed by the U.S. Centers for Disease Control and Prevention (CDC) and authorized for use June 22 by the U.S. Food and Drug Administration (FDA), the new test will replace the previous real-time RT-PCR diagnostic test used during the 2009 H1N1 pandemic.

The new test, called the CDC Influenza 2009 A(H1N1)pdm Real-Time RT-PCR Panel (IVD), can detect human infections with 2009 H1N1 virus with sensitivity and specificity greater than 96 percent for upper respiratory specimens, according to the CDC. Upper respiratory specimens are easily obtainable in a doctor’s office.

Here’s how it works: Amplified viral genetic material generates a fluorescent signal, which is then detected and analyzed by a diagnostic instrument called the Applied Biosystems 7500 Fast DX Realtime PCR Instrument. The test panel and diagnostic system can provide results within four hours, and multiple samples can be tested at the same time.

The CDC did not give a specific date for when physicians will be able to order the new test from CDC-qualified laboratories for detecting 2009 H1N1 flu, but in all likelihood it will be available by the start of the next flu season.

The Centers for Disease Control and Prevention (CDC) is releasing updated interim guidance on infection control measures to prevent transmission of 2009 H1N1 influenza in health care facilities. This guidance applies to the special circumstances of the current 2009 H1N1 pandemic and expands on earlier guidance.

Revisions from earlier guidance include: criteria for identification of suspected influenza patients; recommended time away from work for health care personnel; changes to isolation precautions based on tasks and anticipated exposures; expansion of information on the hierarchy of controls which ranks preventive interventions in the following order of preference: elimination of exposures, engineering controls, administrative controls, and personal protective equipment; and changes to guidance on use of respiratory protection.

Why Update This Guidance Now?

“When the interim infection control guidance for 2009 H1N1 was posted, substantial uncertainties existed regarding the severity of disease and health impact of the novel H1N1 influenza strain, a high proportion of the population was susceptible to the new virus, and the vaccine was not available,” the CDC said. “Circumstances have changed significantly since then. First, a safe and effective vaccine has become widely available. Second, we now have information about the number of cases of disease, hospitalizations, and deaths caused by 2009 H1N1, which can be compared to historical seasonal influenza data.” The current circumstances, the CDC said, justify an update of the recommendations.

In updating this particular guidance, the CDC also will consolidate recommendations for prevention of seasonal flu in health care facilities into a comprehensive, easily accessible document.

To Whom Does This New Guidance Apply?

This guidance applies to health care personnel working in the following settings:  acute care hospitals, nursing homes, skilled nursing facilities, physician’s offices, urgent care centers, outpatient clinics, and home healthcare agencies.  It also includes those working in clinical settings within non-healthcare institutions, such as school nurses or personnel staffing clinics in correctional facilities.

The updated interim guidance still needs to be reviewed by federal government who are experts in the field of medicine. Final guidance will be published in the Federal Register and the CDC will post a notice on its website.

The 2010-2011 seasonal influenza vaccine in the United States will include a pandemic 2009 H1N1 virus in the composition. Unlike this past year, however, the H1N1 inclusion will not likely limit availability. The Advisory Committee on Immunization Practices (ACIP) is recommending the vaccine for everyone 6 months of age and older.

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The U.S. Food and Drug Administration (FDA) has approved a new seasonal influenza vaccine. Agriflu can be used for the prevention of disease caused by flu virus subtypes A and B in people ages 18 and older.

Agriflu was approved using the FDA’s accelerated approval pathway after manufacturer Novartis Vaccines and Diagnostics in Siena, Italy demonstrated the vaccine’s effectiveness in preventing seasonal influenza.

Agriflu is preservative-free and available in single dose, pre-filled syringes administered intramuscularly.

The FDA announced its approval of Agriflu in a Nov. 27 press release, posted on its Web site.

The U.S. Food and Drug Administration (FDA) has approved the use of CSL Limited’s 2009 H1N1 influenza vaccine to include children ages 6 months and older. The vaccine was previously approved only for use in adults, ages 18 years and older. The expanded approval also covers the Australian company’s seasonal flu vaccine.

The vaccines will be available in single-dose, preservative-free, pre-filled syringes, and multi-dose vials.

Google has launched a live online map service that will help your patients find flu shots, both seasonal and H1N1.

The Internet company built the flu shot finder in collaboration with the Department of Health and Human Service (HHS). The service allows users to search within a specified area and locate providers — mostly chain pharmacies — where immunizations are available.

Because of its newness, it may not have all the sites yet, but it will provide consumers with sources for immunizations.

The U.S. Food and Drug Administration (FDA) announced Oct. 23, in response to a request from the U.S. Centers for Disease Control and Prevention (CDC), it has issued an emergency use authorization (EUA) for the investigational antiviral drug peramivir intravenous (IV) in certain adult and pediatric patients with confirmed or suspected 2009 H1N1 influenza infection who are admitted to a hospital.

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