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In the United States, the flu season occurs in the fall and winter. Flu can be a serious illness, mainly for people in high-risk groups such as pregnant women, people 65 or older and those with conditions such as asthma, heart disease, diabetes or any diseases that impact the immune system. Getting flu also puts them at a higher risk for other illnesses such as bronchitis, pneumonia or sinus infections. Getting flu vaccines on time is the best way to avoid flu. As medical practices step up their vaccination efforts, medical billing companies must ensure that their coding staff are up to date with the latest codes to report flu accurately.

In 2005, the CDC established National Influenza Vaccination Week (NIVW) to highlight the importance of continuing flu vaccination through the holiday season and beyond. In 2021, National Influenza Vaccination Week will be observed from December 5-11. CDC and its partners have chosen December, the holiday month for NIVW to remind everyone that even though the holiday season has started, it is not too late to get a flu vaccine. According to the CDC, the overall burden of influenza (flu) for the 2019-2020 was an estimated 35 million flu-related illnesses, 16 million flu-related medical visits, 380,000 flu-related hospitalizations, and 20,000 flu-related deaths. The CDC estimated that flu resulted in 9 million to 41 million illnesses, 140,000–710,000 hospitalizations and 12,000–52,000 deaths annually between 2010 and 2020.

Getting flu shots is the best way to prevent getting sick with flu and passing the flu to others and reduce the risk of illness, hospitalization, and death. The CDC recommends that everyone over 6 months old, including children and healthy young adults to get flu shot every year. Getting vaccinated is especially important for people with chronic conditions such as cancer, asthma or other lung diseases, diabetes, and heart disease who are at a higher risk for severe flu-related complications.

Influenza vaccines cause antibodies to develop in the body about two weeks after vaccination, which provide strong protection against infection with the viruses that are used to make vaccine. Available influenza vaccines include quadrivalent inactivated influenza vaccine [IIV4], recombinant influenza vaccine [RIV4], or live attenuated influenza vaccine (LAIV4).

ICD-10 codes for flu symptoms

Common flu symptoms include cough, fever, headaches, sore throat, stuffy nose, aches and pain, fatigue, and more. Such symptoms can also be reported in claims using related ICD-10 codes such as

  • R05 Cough
  • R50.9 Fever, unspecified
  • R51 Headache
  • R06.02 Shortness of breath
  • R06.7 Sneezing

Influenza vaccination

Z23 code represents the flu vaccination, which is the same for any immunization.

  • Z23 Encounter for immunization

CPT vaccination codes

CPT codes to report influenza virus vaccine include –

  • 90662 Influenza virus vaccine (IIV), split virus, preservative free, enhanced immunogenicity via increased antigen content, for intramuscular use
  • 90672 Influenza virus vaccine, quadrivalent, live (LAIV4), for intranasal use
  • 90674 Influenza virus vaccine, quadrivalent (ccIIV4), derived from cell cultures, subunit, preservative and antibiotic free, 0.5 mL dosage, for intramuscular use
  • 90682 Influenza virus vaccine, quadrivalent (RIV4), derived from recombinant DNA, hemagglutinin (HA) protein only, preservative and antibiotic free, for intramuscular use
  • 90685 Influenza virus vaccine, quadrivalent (IIV4), split virus, preservative free, 0.25 mL dosage, for intramuscular use
  • 90686 Influenza virus vaccine, quadrivalent (IIV4), split virus, preservative free, 0.5 mL dosage, for intramuscular use
  • 90687 Influenza virus vaccine, quadrivalent (IIV4), split virus, 0.25 mL dosage, for intramuscular use

HCPCS codes

  • Q2034 Influenza virus vaccine, split virus, for intramuscular use (Agriflu)
  • Q2035 Influenza virus vaccine, split virus, when administered to individuals 3 years of age and older, for intramuscular use (Afluria)
  • Q2036 Influenza virus vaccine, split virus, when administered to individuals 3 years of age and older, for intramuscular use (Flulaval)
  • Q2037 Influenza virus vaccine, split virus, when administered to individuals 3 years of age and older, for intramuscular use (Fluvirin)
  • Q2038 Influenza virus vaccine, split virus, when administered to individuals 3 years of age and older, for intramuscular use (Fluzone)
  • Q2039 Influenza virus vaccine, not otherwise specified

As a person’s immune protection from vaccination declines over time, annual vaccination is crucial for optimal protection against flu. Preventive actions the CDC recommends to stop the spread of germs are – avoiding close contact with sick people, covering coughs and sneezes, washing hands often with soap and water, not touching your eyes, nose, and mouth, and cleaning and disinfecting surfaces and objects that may be contaminated with viruses.

Physicians can rely on professional medical billing and coding services to assign the correct codes and bill flu shots and treatments.

Get involved in National Influenza Vaccination Week – spread awareness about the importance of getting vaccinated within the recommended time.