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Calling the Shots: How To Choose The Flu Vaccine To Use This Year

Health Insurance Companies Process 1 in 5 Claims Wrong

Flu season is once again upon us, and the CDC recommends that everyone six months or older receive a flu vaccine, with it being even more important for those who have a high risk for complications, like the elderly, children under five, and pregnant women.

This season, there are a number of different flu vaccines recommended for different groups of people, dependent on age, health and relevant allergies.

What Vaccines are Recommended this Year?

This year, doctors have some options in addition to traditional flu shots for their patients.

Standard dose flu shots: Most standard dose trivalent shots are produced using a virus that’s grown in eggs. Different trivalent formulations are used for various age groups, with most being given in the arm muscle. This is the go-to vaccine formula for most people aged 18-64.

High-dose for older people: A higher dose trivalent vaccine has been formulated for people aged 65 or older. Fluzone High-Dose is made by Sanofi Pasteur Inc. This vaccine contains four times more antigen than regular flu shots, with the intention to boost the immune response.

Shot made with adjuvant for older people: A new seasonal flu vaccine, Fluad, has been approved this season that contains adjuvant for adults aged 65 and over. An adjuvant is a vaccine addition that creates a stronger immune response. This particular vaccine is the first of its type in the U.S.

Shot made with virus grown in cell culture:  Cell-based vaccines are created by growing viruses in animal cells, as opposed to the egg-based process for most flu vaccines. Flucelvax is stored frozen, so can be grown more quickly in the event of a major outbreak, and is also appropriate for those with egg allergies.

Shot made using recombinant vaccine: This type of vaccine, Flublok, doesn’t use a live flu virus or chicken eggs in production. But it does have a shorter shelf life than other influenza vaccines, with an expiration date of nine months from manufacture. This vaccine is not dependent on egg supplies or limited by virus selection that can only be used for growth in eggs, making it easy to ramp up production quickly if needed. It’s also suitable for people with egg allergies.

No nasal spray: One important note is that the CDC recommends not using any nasal spray flu vaccine this season.

Coding for Claims

We put together a handy graphic that gives all of the proper Medicare Q codes for influenza vaccines. Here you will find all of the administration and diagnosis codes for flu vaccines you administer within your practice

is a 20 year veteran of healthcare having managed medical practices. He advises medical practices, physicians and practice administrators on how to run their practice and manage their medical billing and revenue cycle management. Manny speaks, blogs and makes videos at www.CaptureBilling.com, a blog that is tops in the medical billing and coding field. READ MORE

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The analysis of any medical billing or coding question is dependent on numerous specific facts -- including the factual situations present related to the patients, the practice, the professionals and the medical services and advice. Additionally, laws and regulations and insurance and payer policies (as well as coding itself) are subject to change. The information that has been accurate previously can be particularly dependent on changes in time or circumstances. The information contained in this web site is intended as general information only. It is not intended to serve as medical, health, legal or financial advice or as a substitute for professional advice of a medical coding professional, healthcare consultant, physician or medical professional, legal counsel, accountant or financial advisor. If you have a question about a specific matter, you should contact a professional advisor directly. CPT copyright American Medical Association. All rights reserved. CPT is a registered trademark of the American Medical Association.

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