What should State Medicaid programs do with regard to the new H1N1 codes that have recently been published?
Four new codes plus one revised code were recently published and are available for use by providers and health insurers in submitting/reimbursing claims for H1N1-related services. These codes become part of the standard medical code sets which are used by providers and health insurers, public and private, in transacting electronic medical claims under HIPAA. Two new G-HCPCS codes were published, effective September 1, 2009. Both codes, G9141 for H1N1 immunization administration and G9142 for H1N1 vaccine, were added to Medicare’s October 2009 update of their physician fee schedule. Effective September 28, 2009, CPT created new code 90470 for H1N1 immunization and revised code 90663 to read “Influenza virus vaccine, pandemic formulation, H1N1.” Also, effective October 1, 2009 a new ICD-9-CM diagnosis code was established for H1N1 (488.1). These new and revised codes will enable State Medicaid agencies and their providers to identify, track and transact claims specifically for H1N1-relat
