CODING & REIMBURSEMENT FOR THE 2023-2024 SEASON

CPT Codes for Flu Vaccines and Flu Vaccine Reimbursement Information

Influenza Vaccine - Fluzone High-Dose Quadrivalent Fluzone Quadrivalent Influenza Vaccine

For illustrative purposes only.

FLUZONE HIGH-DOSE QUADRIVALENT
(SINGLE-DOSE PREPARATION)1-3

Presentation
and Doseᵃ
10 single-dose
0.7-mL prefilled
syringes
Vaccine CPTᵇ Code
90662
When the Payer Requires the
Outer Carton NDCᶜ
49281-0123-65
When the Payer Requires the
Unit-of-Use NDC
49281-0123-88
CVXᵈ Code
197

90662=High-dose inactivated influenza vaccine, quadrivalent (HD-IIV4), split virus, preservative free, enhanced immunogenicity via increased antigen content, for intramuscular use.

Flublok Quadrivalent Influenza vaccine

For illustrative purposes only.

FLUBLOK QUADRIVALENT
(SINGLE-DOSE PREPARATION)2-4

Presentation
and Doseᵃ
10 single-dose
0.5-mL prefilled
syringes
Vaccine CPTᵇ Code
90682
When the Payer Requires the
Outer Carton NDCᶜ
49281-0723-10
When the Payer Requires the
Unit-of-Use NDC
49281-0723-88
CVXᵈ Code
185

90682=Recombinant quadrivalent influenza vaccine (RIV4), derived from recombinant DNA, hemagglutinin (HA) protein only, preservative and antibiotic free, for intramuscular use.

Fluzone Quadrivalent Influenza Vaccine Fluzone Quadrivalent Influenza Vaccine

For illustrative purposes only.

FLUZONE QUADRIVALENT
(SINGLE-DOSE PREPARATION)2,3,5

Presentation
and Doseᵃ
10 single-dose 0.5-mL prefilled syringes
Vaccine CPTᵇ Code
90686
When the Payer Requires the
Outer Carton NDCᶜ
49281-0423-50
When the Payer Requires the
Unit-of-Use NDC
49281-0423-88
CVXᵈ Code
150

90686=Inactivated quadrivalent influenza vaccine (IIV4), split virus, preservative free, 0.5-mL dosage, for intramuscular use.

FLUZONE QUADRIVALENT
(MULTI-DOSE PREPARATION)2,3,5

Presentation
and Doseᵃ
0.25-mL dose taken from 5-mL multi-dose vial0.5-mL dose taken from 5-mL multi-dose vial
Vaccine CPTᵇ Code
90687 (0.25-mL dose)90688 (0.5-mL dose)
When the Payer Requires the
Outer Carton NDCᶜ
49281-0639-15
When the Payer Requires the
Unit-of-Use NDC
49281-0639-78
CVXᵈ Code
158

90687=Inactivated quadrivalent influenza vaccine (IIV4), split virus, 0.25-mL dosage, for intramuscular use.

90688=Inactivated quadrivalent influenza vaccine (IIV4), split virus, 0.5-mL dosage, for intramuscular use.

Source: 2021 CPT.
Current Procedural Terminology is a registered trademark of the American Medical Association.
aA maximum of 10 doses can be withdrawn from the multi-dose vial.
bCurrent Procedural Terminology.
cNDC=National Drug Code.
dCode that indicates products used in vaccination.
Notice: This coding information is provided for informational purposes only and does not constitute legal or reimbursement advice. It is not intended to substitute for the physician’s independent
diagnosis or treatment of each patient. The information contained herein is gathered from various resources and is subject to change. Providers are solely responsible for the accuracy of all coding and
claims submitted for reimbursement to any third-party payer.

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INDICATIONS

Fluzone Quadrivalent, Flublok Quadrivalent, and Fluzone High-Dose Quadrivalent are vaccines indicated for active immunization against disease caused by influenza A subtype viruses and type B viruses contained in the vaccine. Fluzone Quadrivalent is approved for use in persons 6 months of age and older. Flublok Quadrivalent is approved for use in persons 18 years of age and older. Fluzone High-Dose Quadrivalent is approved for use in persons 65 years of age and older.

IMPORTANT SAFETY INFORMATION

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Fluzone Quadrivalent, Flublok Quadrivalent, and Fluzone High-Dose Quadrivalent should not be administered to anyone who has had a severe allergic reaction (e.g., anaphylaxis) to any component of the vaccine (including egg protein for Fluzone Quadrivalent and Fluzone High-Dose Quadrivalent). In addition, Fluzone Quadrivalent and Fluzone High-Dose Quadrivalent should not be administered to anyone who has had a severe allergic reaction after previous dose of any influenza vaccine.

Appropriate medical treatment and supervision must be available to manage possible anaphylactic reactions following administration of the vaccine.

If Guillain-Barré syndrome has occurred within 6 weeks following previous influenza vaccination, the decision to give Fluzone Quadrivalent, Flublok Quadrivalent, and Fluzone High-Dose Quadrivalent should be based on careful consideration of the potential benefits and risks.

If Fluzone Quadrivalent, Flublok Quadrivalent, and Fluzone High-Dose Quadrivalent are administered to immunocompromised persons, including those receiving immunosuppressive therapy, the immune response may be lower than expected.

Vaccination with Fluzone Quadrivalent, Flublok Quadrivalent, and Fluzone High-Dose Quadrivalent may not protect all recipients.

Syncope (fainting) has been reported following vaccination with Fluzone Quadrivalent. Procedures should be in place to avoid injury from fainting.

For Fluzone Quadrivalent, in children 6 months through 35 months of age, the most common injection-site reactions were pain or tenderness, erythema, and swelling; the most common solicited systemic adverse reactions were irritability, abnormal crying, malaise, drowsiness, appetite loss, myalgia, vomiting, and fever. In children 3 years through 8 years of age, the most common injection-site reactions were pain, erythema, and swelling; the most common solicited systemic adverse reactions were myalgia, malaise, and headache. In adults 18 years and older, the most common injection-site reaction was pain; the most common solicited systemic adverse reactions were myalgia, headache, and malaise.

For Flublok Quadrivalent, in adults 18 through 49 years of age, the most common injection-site reactions were tenderness and pain; the most common solicited systemic adverse reactions were headache, fatigue, myalgia, and arthralgia. In adults 50 years of age and older, the most common injection-site reactions were tenderness and pain; the most common solicited systemic adverse reactions were headache and fatigue.

For Fluzone High-Dose Quadrivalent, in adults 65 years of age and older, the most common injection-site reaction was pain; the most common solicited systemic adverse reactions were myalgia, headache, and malaise.

For Fluzone Quadrivalent, Flublok Quadrivalent, and Fluzone High-Dose Quadrivalent, other adverse reactions may occur.

Before administration, please see the full Prescribing Information for Fluzone Quadrivalent, Flublok Quadrivalent, or Fluzone High-Dose Quadrivalent. Also, please see complete Patient Information for Fluzone Quadrivalent or Fluzone High-Dose Quadrivalent.

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