V05.3. Need for Prophylactic immunization against Viral Hepatitis
For an inpatient claim for reimbursement, the ICD-9-CM diagnosis codes would be V04.81 for the reason for an influenza vaccination (need for prophylactic vaccination against influenza) and V03.82 (need for prophylactic vaccination against streptococcus pneumoniae, aka pneumococcal pneumonia) for the pneumonia vaccination. The ICD-9-CM procedure codes would be 99.55, Prophylactic administration of vaccine against disease, for the pneumococcal vaccine and 99.52, Prophylactic vaccination against influenza, for the flu vaccination.Outpatient claims are coded differently with more complex specificity related to patient demographics, etc. than the inpatient ICD-9-CM codes. For a quick reference to the proper coding for these for an outpatient episode of care, see the related link below to the official CMS information for CPTand pharmaceutical codes and additional guidelines for coding for Medicare.
Need for prophylactic vaccination and inoculation against influenza ~ ICD-9-CM code V04.81
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ICD 9 CM Code E875.1- Contaminated substance injected or used for vaccination.
Whether it is needed or not depends upon why you are coding it. If for a provider claim, then most insurers will need that code on the claim if you are billing for the immunization, but that will be an insurer's requirement that varies.The ICD-9-CM diagnosis code for Need for prophylactic vaccination against influenza is V04.81.The ICD-9-CM procedure code for administration of the vaccine is 99.52, Prophylactic vaccination against influenza.CPT 90658 is no longer valid for Medicare claims for vaccination, as of 1/1/11.Medicare requires HCPCS code G0008 in place of the CPT code.Plus, Medicare has developed five new HCPCS codes for government study of the flu vaccines by manufacturer brand name:Q2035 AfluriaQ2036 FlulavalQ2037 FluvirinQ2038 FluzoneQ2039 Not Otherwise Specified brand (NOS)See the related link below for more information
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