Posts Tagged ‘Vaccine’

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.

The U.S. Food and Drug Administration (FDA) approved, Oct. 19, the use of the seasonal influenza vaccine Fluarix for children ages 3 to 17 years. This vaccine, which contains inactivated (killed) influenza A and B viruses, was previously approved for use in adults, ages 18 years and older.

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If you’re confused about carrier rules for coding H1N1 vaccines, you’re not alone. Choosing H1N1 codes  in regard to Medicare and private insurance guidelines, and when to use a modifier can leave you dumbfounded. To answer your H1N1 questions, here’s the low-down on Medicare policies vs. private insurer policies.

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The National Institutes of Health (NIH) is preparing to launch the first government-sponsored clinical trial to determine what dose of the 2009 H1N1 influenza vaccine is needed to induce a protective immune response in people with asthma, especially severe asthmatics. The study is cosponsored by the National Institute of Allergy and Infectious Diseases (NIAID) and the National Heart, Lung, and Blood Institute (NHLBI), both part of NIH. Read more »

A recent update to the ICD-9-CM Official Guidelines for Coding and Reporting gives coders a choice of diagnosis codes to differentiate between the two types of influenza virus patients may present with this year. Read more »

About 600,000 doses of H1N1 vaccine were delivered Oct. 6 to the 25 states that placed initial orders, according to an Oct. 1 Centers for Disease Control and Prevention (CDC) press conference, but two of the at-risk groups who need the vaccine most won’t be able to receive it.

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The Influenza A (H1N1) vaccine is expected to ship mid-October. Will your billing staff be ready for the influx of claims once your physicians’ office begins administering the vaccine?

Medicare Part B will pay for the administration of the H1N1 (swine flu) vaccine. Read more »

Accurate payment for seasonal influenza (flu) virus vaccines requires precise coding. And to accomplish that, coders have to pay attention to details.

“Make sure you code correct route, correct product, correct ICD-9,” says Cathy Gray, RHIT, CCS, CPC-I, CCC, CGIC, with Henry Ford Health System in Detroit, in a recent issue of Pediatric Coding Alert.

Ask yourself the following questions:

1. Is the flu product the patient receiving preservative-free?

Preservative-free products cost more and, as such, reimburse at a higher rate. Report the wrong product code and your office loses money.

2. How old is the patient?

You should also base your product code selection on the patient’s age. Vaccines administered to individuals 3 years of age and older pay more than those given to children 6-35 months.

3. What came first, the shot or the spray?

The order in which you code services can affect how much your practice is reimbursed. If a patient receives an intranasal flu vaccine at the same time as an injectable vaccine, for example, code the injectable first.

4. Which vaccine administration code set should I use?

You should use the administration code set that best represents the patient’s age and physician (or other health care professional) counseling, advises Pediatric Coding Alert. Consult your payer to confirm whether it pays more for 90465 – +90468 than for the comparable 90471 – +90474 code set.

Read the complete Pediatric Coding Alert article, entitled “4 Coding & Billing Steps Boost Your Flu Prevention Pay by $38.”

Two new Level II HCPCS codes were added to the 2009 Medicare Physician Fee Schedule Database (MPFSDB) in the October update. Effective Sept. 1, report code G9142 Influenza A (H1N1) vaccine, any route of administration to describe the H1N1 vaccine itself, and G9141 Influenza A (H1N1) immunization administration (includes the physician counseling the patient/family to describe the administration of the H1N1 vaccine.

Providers should report one unit of G9141 for each administration of the H1N1 vaccine. Read more »

Department of Commerce (DOC) Secretary Gary Locke, Department of Homeland Security (DHS) Secretary Janet Napolitano and Health and Human Services (HHS) Secretary Kathleen Sebelius held a joint news conference Aug. 19 to announce new Centers for Disease Control and Prevention (CDC) guidance for businesses to prepare for and respond to the upcoming flu season.

Actions Employers Should Take Now

Emphasis was made on businesses implementing a flexible work policy that permitted employees to stay home if they or family members became ill or were exhibiting flu-like symptoms.

DOC Secretary Locke said at the conference, “Some businesses now require workers to provide doctors’ notes or other paperwork to prove that they or their love ones had to miss work because of illness. That’s a requirement that employers should consider dropping.” Such a requirement, Secretary Locke reasoned, would put too much of a burden on health care facilities at a time when they will be operating at full capacity.

Businesses would do well to align with local health departments in adopting common sense policies, federal officials said, such as instructing employees to wash hands frequently and cover coughs. Employers should also encourage employees to receive the flu vaccine and, when available, the H1N1 vaccine. Somewhere between 45 million and 52 million doses of H1N1 vaccine are expected to be available by mid-October, according to an Aug. 21 CDC press briefing.

“Let’s not just play ‘wait and see.’ Let’s be proactive,” said DHS Secretary Napolitano.

Recommended Action Steps under Current Flu Conditions

While it is important for businesses to look after employees, they should also implement certain steps for self preservation. In particular, the CDC recommends businesses prepare for increased numbers of employee absences due to illness, or closure of schools and childcare programs, and plan ways for essential business functions to continue. Recommendations include cross training employees and implementing a work-from-home policy.

Under Conditions with Increased Severity

In the event that conditions worsen, employers should consider active screening of employees who report to work. Other things businesses can do to limit exposure include disinfecting common surfaces, increasing social distancing, and canceling non-essential travel and meetings.

New CDC H1N1 guidance for colleges, universities, and institutions of higher education was also released Aug. 20.

Health care workers can find a plethora of information regarding flu preparedness, such as the CDC planning guide “10 Steps You Can Take: Actions for Novel H1N1 Influenza Planning and Response for Medical Offices and Outpatient Facilities,” available on the Flu.gov Web site.