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Provider Digest | Issue 56

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Prepare for flu season, review influenza billing/coding updates + join our vaccination webinar

What providers need to know this flu season

The Alliance has launched its annual campaign to encourage members to get their flu vaccine.

Please join us in encouraging Alliance members to get vaccinated. Flu vaccines are available at no cost for Alliance members.

When patients come in to get the flu vaccine, it’s also a great opportunity to encourage them to get the updated COVID-19 vaccine and any other vaccines due.

Where can Alliance members get flu vaccines?

Adults can get a flu vaccine at:

  • A local pharmacy.
  • A flu vaccine clinic.
  • Their primary doctor’s office.

Children and adolescents under age 19 need to get the flu vaccine at their doctor’s office. Members can get a flu vaccine from a provider they are not currently linked to – no referral is needed. Local health departments may also be offering flu, COVID-19 and other vaccine clinics.

Flu shots will be available for Merced County members at the Merced Community Health Fair on Oct. 6, 2024. Members who get their flu shot at the fair will receive a $25 gift card. Find more information on our website.

Providers can get information about this flu season on the CDC website. We also have a flu flyer available for handout to members. More information for members is also available at on our website.

Flu incentive for members

Alliance members with children ages 7 to 24 months who get their two flu vaccine doses between September and May will be entered into a monthly raffle for a $100 Target gift card. Read more about this incentive on our webpage. 

2024-2025 Influenza Season Billing/Coding Updates

Vaccine composition for the 2024-25 U.S. influenza season

The FDA Vaccine and Related Biological Products Advisory Committee recommended that the trivalent formulation of egg-based influenza vaccines for the U.S. 2024-2025 influenza season contain the following:

  • A A/Victoria/4897/2022 (H1N1)pdm09-like virus.
  • An A/Thailand/8/2022 (H3N2)-like virus.
  • A B/Austria/1359417/2021 (B/Victoria lineage)-like virus.

The committee recommended that the trivalent formulation of cell- or recombinant-based influenza vaccines for the U.S. 2024-2025 influenza season contain the following:

  • An A/Wisconsin/67/2022 (H1N1)pdm09-like virus.
  • An A/Massachusetts/18/2022 (H3N2)-like virus.
  • A B/Austria/1359417/2021 (B/Victoria lineage)-like virus.
All Alliance lines of business (Effective date Sept. 1, 2024 through June 30, 2025)
Applies to members linked to your practice, non-linked members (no referral required) or administrative members.
Vaccine Name Dosage Age Group CPT Code
Afluria® (IIV3)

 

0.5 mL PFS 10-bx* 3 Years & Older 90656
5 mL MDV

.5 mL/dose

3 Years & Older 90658
Afluria® Pediatric (IIV3) 0.5 mL (.25mL dose) MDV 10-bx* 6 to 35 months 90657
Fluad® (IIV) 0.5 mL PFS 10-bx* 65 years & older 90653
Fluarix® (IIV3) 0.5 mL PFS 10-bx* 3 Years & Older 90656
Flublok® 0.5 mL PFS 10-bx* 18 years & older 90673
Flucelvax® (ccIIV3)

 

0.5 mL PFS 10-bx* 6 months & older 90661
5 mL MDV

.25 mL/dose

6 months & older 90661
FluLaval® (IIV3) 0.5 mL PFS 10-bx* 6 months & older 90656
FluMist®(LAIV3) 0.2 mL spray 10-bx* 2 to 49 years 90660
Fluzone® (IIV)

 

0.5 mL PFS 10-bx* 6 months & older 90656
5 mL MDV

.25 mL/dose

6 to 35 months 90657
5 mL MDV

.5 mL/dose

3 Years & Older 90658
Fluzone® High-Dose (IIV) 0.5 mL PFS 10-bx* 65 years & older 90662

 

Immunization Registries
Vaccine Name Immunization Service Name with CVX*
Afluria®

 

Influenza, injectable, trivalent, pres free (140)
Influenza, injectable, trivalent (141)
Afluria® Pediatric Influenza, injectable, trivalent, pres free, ped (141)
Fluad® Influenza, injectable, subunit, adjuvanted, pres free (168)
Fluarix® Influenza, injectable, trivalent, pres free (140)
Flublok® Influenza, recombinant, trivalent, injectable, pres free (155)
Flucelvax®

 

Influenza, injectable, MDCK, pres free, trivalent (153)
Influenza, injectable, MDCK, trivalent (320)
FluLaval® Influenza, injectable, trivalent, pres free (140)
FluMist® Influenza, live, intranasal, trivalent (111)
Fluzone®

 

Influenza, injectable, split virus, trivalent, pres free (140)
Influenza, injectable, split virus, trivalent (141)
Fluzone® High-Dose Influenza, injectable, high dose split virus, pres fress (135)

 *Correct CVX code for immunization registries is needed for Care Based Incentives (CBI).

To learn about the Vaccines For Children (VFC) program and how to bill for VFC, see our previous Digest article.

Register for the Children & Adolescent Vaccination Lunch and Learn!

The Alliance is hosting a Child & Adolescent Vaccination Lunch and Learn in collaboration with Merck & Co., Inc. We are excited to have Reena Gulati, MD, MPH from Merck & Co., Inc., to present on building vaccine confidence and addressing vaccine hesitancy.

Key topics that the webinar will cover include:

  • Vaccine confidence and how it can impact vaccination rates across populations.
  • Common concerns underlying vaccine hesitancy and barriers regarding vaccination.
  • Strategies to build vaccine confidence in vaccine-hesitant patients.

Webinar details and registration:

When: Wednesday, Oct. 9, 2024, from noon to 1 p.m.

Where: Online via Microsoft Teams.

Register and read more details on our provider event webpage, or contact a Provider Relations Representative at 800-700-3874, ext. 5504.