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2013-2014 Seasonal Flu Vaccine Information

Many Blue Cross and Blue Shield of North Carolina (BCBSNC) members are eligible to receive a flu shot at no cost.  Providers should check the member's preventive care benefits to see if they qualify and if any applicable copayment, deductible or coinsurance applies.

 

Eligible BCBSNC commercial members (both individual and group) can receive their seasonal flu shot at the following locations:

 

·         Physician's Office

·         Immunizing Pharmacist

·         Immunizing Health Department

·         CVS Minute Clinic

·         Their Employer’s Worksite Flu Shot Clinic (if applicable)

 

For additional details regarding the 2013-2014 BCBSNC seasonal flu program for commercial members, please see our Stick It to the Flu website.

 

Flu Vaccines Available for the 2013-2014 Flu Season:

 

 

§ Flu vaccine (trivalent) - Combo vaccine with two strains of influenza + H1N1 called “trivalent vaccine”

o  CPT codes 90655-90658 and 90661 (depending on age and if it is preservative free or not)

§ Flu vaccine/FluMist (quadrivalent) - Combo vaccine with three strains of influenza + H1N1 called "quadrivalent vaccine"

o  CPT 90672 - intranasal, ages 2-49

o  CPT 90685 - intramuscular, ages 6-35 months

o  CPT 90686 - intramuscular, ages 3 and up
 

§ Intradermal flu shot 

o  CPT 90654
   

§ Fluzone high dose (ages 65 and older)

o  CPT 90662
 

§ Administration codes for flu vaccine:

o  CPT codes 90460-90461 pertain to children younger than 18

o  CPT codes 90471-90474 are for patients ages 18 and older when no counseling is involved

o  If the member also has Medicare coverage, providers should use administration code G0008 as 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 only go to the doctor for a flu shot.  However, if the patient sees the doctor for other services, an office visit copayment may be charged.  Blue Medicare patients can also receive their annual flu shot at CVS Minute Clinics, an immunizing health department, or from an 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.