The ICD-10 code to use for flu vaccination is Z23, encounter for immunization. There are many CPT codes to describe influenza vaccine, varying by manufacturer, product and age group. Code according to the product you are using to accurately bill for flu vaccine.
Coding & Reimbursement 90662=Inactivated Influenza Vaccine, quadrivalent (IIV4), split virus, preservative free, enhanced immunogenicity via increased antigen content, for intramuscular use.
For immunization administration other than COVID-19, codes 90460–90474 are reported for the administration of the vaccine, along with the appropriate vaccine/toxoid code (90476–90756) targeting the organism.
According to the guidelines (page 72 2016 ICD-10 code book) Z23 is not listed as one that can be used as primary diagnosis.
encounter for a vaccinationCode Z23 is used to indicate any encounter for a vaccination. The procedure codes are used to identify the type of the immunization given and how it was administered. All Z codes must be accompanied by a corresponding procedure code.
90471 One vaccine, single or combination vaccine/toxoid. Immunization administration (includes percutaneous, intradermal, subcutaneous or intramuscular injections).
Vaccine Administration Code(s) Administration codes track which dose in the regimen is being administered. NDC 10/NDC11 The National Drug Code (NDC) uniquely identifies human drugs in the United States; it can be found on the vial containing the vaccine.
Other specified counselingICD-10 code Z71. 89 for Other specified counseling is a medical classification as listed by WHO under the range - Factors influencing health status and contact with health services .
Code Z23, which is used to identify encounters for inoculations and vaccinations, indicates that a patient is being seen to receive a prophylactic inoculation against a disease. If the immunization is given during a routine preventive health care examination, Code Z23 would be a secondary code.
Z23 is the ICD-10 code that identifies an encounter for immunization(s). If a vaccine is given within the same visit as other services, eg, preventive health care, the ICD-10 code for that service would be primary, and Z23 would be a secondary ICD-10 code.
BillingAll providers who administer the flu shot must accept assignment.You may use roster billing or submit an individual claim. ... Entities, like local health facilities, must get a national provider identifier (PDF) if they've never submitted Medicare claims.
Immunizations, vaccinations, or inoculations are covered by Medicare only when there has been direct exposure of the associated disease to the patient and there is significant risk that the patient could contract the disease as a result of the exposure.
90686, “Influenza virus vaccine, quadrivalent (IIV4), split virus, preservative free, 0.5 mL dosage, for intramuscular use.” 90688, “Influenza virus vaccine, quadrivalent (IIV4), split virus, 0.5 mL dosage, for intramuscular use.”
9046090460 – Immunization administration through 18 years of age via any route of administration, with counseling by physician or other qualified health care professional; first or only component of each vaccine or toxoid administered.
CPT® Code 90686 in section: Influenza virus vaccine, quadrivalent.
If you administer the intranasal influenza vaccine only, report 90473. If you administer an influenza vaccine in addition to other vaccines, report the influenza injection with 90472 or the intranasal with 90474.