The AMA issued a new CPT code for influenza vaccine Flucelvax, CPT 90674, effective August 1, 2016, for Medicare claims. However, Medicare claims processing systems will not be able to accept the new code until January 1, 2017. Until then, your options are:
- Hold claims containing CPT 90674 or
- MACs may direct use of an NOC code to allow billing for the vaccine for dates of service on or after August 1, 2016, and before January 1, 2017
Cahaba has asked providers to bill Q2039 until 12/31/2016 in place of 90674. Add in Item 19 of the 1500 claim form, or in 2400 loop, SV101-7 field of the EMC claim the following statement: WORK AROUND BILLING FOR 90674. Adding this statement will trigger the processors to manually price the Q2039 at the CMS rate for 90674.
Finally, if you bill institutional claims, CPT 90674 will not be implemented until February 20, 2017.