Billing cpt 90657, 90658, 90659 - flu vaccinations

What are the specific codes that must be used?

The following codes are used for flu vaccinations:

HCPCS Code Description

90657 Influenza virus vaccine, split virus, 6-35 months dosage, for intramuscular or jet injection use

90658 Influenza virus vaccine, split virus, 3 years and above dosage, for intramuscular or jet injection use

90659* Influenza virus vaccine, whole virus, for intramuscular or jet injection use

G0008 Administration of Influenza Virus Vaccine

Diagnosis Code Description

V04.8 Influenza Vaccination

Providers are responsible for submitting the correct codes on their claims. The code should be chosen based on the description of the drug and the age of the patient. Codes are not interchangeable.

What should be entered in item 11 of the CMS-1500 when Medicare is
known to be the secondary payer?

For all flu vaccination claims submitted to a carrier, item 11 of the preprinted CMS-1500 should show “NONE.”


Sometimes an entity receives donated vaccine or receives donated services for the administration of the vaccine. In these cases, may the provider bill Medicare for the portion of the vaccination that was not donated?
Yes.

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