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90674 Flucelvax Quad Ongoing Payment Problem Amerigroup NY

Hi,
We billed 90674 starting in September. My provider rep told me that the 2017-2018 flu shot codes were not added into the system and it would take 4-6 weeks. We have been contacting him and other people at the insurance and he even had a meeting with the dr and all codes were denied incorrectly as capitated and we still get the answer from them that they are still "working on it." Did anyone else have this problem or any ideas on how I can fix and get paid? We have had problems with this insurance and flu codes in past. The provider rep and supervisors are mainly unresponsive. I had to send him list of 2017-2018 codes twice.
Thank you in advance for any help!

Medical Billing and Coding Forum

CPT 90674 – New Code for Influenza Vaccine


The American Medical Association issued a new Current Procedural Terminology (CPT) code for influenza vaccine Flucelvax, CPT 90674, effective August 1, 2016 for Medicare claims. However, Medicare claims processing systems will not be able to accept the new code until January 1, 2017. Until this time, you may hold claims containing CPT 90674. Alternatively, Medicare Administrative Contractors (MACs) may direct use of a Not Other Classified (NOC) code to allow billing for the vaccine for dates of service on or after August 1, 2016, and before January 1, 2017. Check with your MAC for this information and other interim billing instructions. Finally, if you bill institutional claims, note that code CPT 90674 will be implemented on February 20, 2017.


Coding Ahead

Medicare to Pay for New Influenza Code, 90674

Medicare will pay for the newest CPT influenza virus vaccine, 90674, the Centers for Medicare & Medicaid Services (CMS) announced in a recent transmittal. But since 2017 codes won’t go into effect until after the first of the year, it won’t be until January 3, 2017. However, claims with dates of services on or after August 1 […]
AAPC Blog