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2017 - 2018 Seasonal Flu Vaccine Information

Many Blue Cross and Blue Shield of North Carolina (Blue Cross NC) members are eligible to receive a flu shot at no cost. Providers should check members’ preventive care benefits to see if they qualify, and if any applicable copayments, deductibles, or coinsurance amounts apply.

Eligible Blue Cross NC commercial members (both individual and group) can receive their seasonal flu shots at the following locations:

  • Physicians’ offices
  • Immunizing pharmacists
  • Immunizing health departments
  • Minute Clinics
  • Employers’ worksite flu shot clinics (if applicable)

For additional details about the 2017-2018 Blue Cross NC seasonal flu program for commercial members, please see What’s True About the Flu.

The following vaccines are available for the 2017-2018 Flu Season:

Flu Vaccine

CPT Codes

Notes

Flu vaccine (trivalent)

  • CPT 90656 and 90658 (depending on age and whether or not the vaccine is preservative-free)
  • CPT 90653 – intramuscular for ages 65+
  • CPT 90662 – high dose for ages 65+
  • CPT 90673 – intramuscular ages 18+

Combo vaccine with two strains of influenza + H1N1

Flu vaccine/FluMist (quadrivalent)

  • CPT 90630 – intradermal for ages 18 – 64
  • CPT 90672 – intranasal, ages 2 – 49
    NOTE: The Advisory Committee on Immunization Practices recommends that FluMist (LAIV4) NOT be used during the 2017 – 2018 season.
  • CPT 90674 – intramuscular, ages 4+
  • CPT 90682 – intramuscular ages 18+
  • CPT 90685 and 90687 – intramuscular, ages 6 – 35 months
  • CPT 90686 and 90688 – intramuscular, ages 3 and up
  • Q2039/90749/90756 – intramuscular ages 4+ (90756 effective January 1, 2018)

Combo vaccine with three strains of influenza + H1N1

 

Administrative Codes for Flu Vaccine

Patients

CPT Codes

Children younger than 18

90460-90461

Patients ages 18 and older, when no counseling is involved

90471-90474

Patients who also have Medicare coverage

G0008 (Medicare requires this code for influenza)

 

For Blue Medicare Members

Blue MedicareSM HMO and Blue MedicareSM PPO members are eligible to receive flu shots without a copayment if they go to in-network doctors for their flu shots. However, if a patient sees the doctor for other services, an office visit copayment may be charged. Blue Medicare patients can also receive their annual flu shots at any in-network immunizing pharmacist.

Providers may access the Quick Reference Medicare Immunization Billing guide for complete details about immunization procedure codes and descriptors for Blue Medicare members. Please review the Blue Medicare flu shot web page for specific details.