It’s that time of year again when school supplies are purchased and flu shots are given. A silver lining of the Covid-19 pandemic, flu transmission was relatively low in the 2020-2021 season but it is unknown what is in store for 2021-2022 season. Each year seems to be a new experience and a new scurry to aggregate the new NDC data to update EMRs. For the second year, we have simplified this process by creating a NDC to billing crosswalk! The Influenza Tool for 2021-2022 can be found on our website PharmacyRevenueCycle.com.
This crosswalk contains the updated NDC for the 2021-2022 formulations. The Fluad (trivalent) formulation will not be manufactured this year and has been removed from our tool. Otherwise, there are minimal changes to influenza formulations.
Pharmacy and revenue integrity teams ensure the new NDCs are updated for accurate billing.
Pharmacy and revenue integrity teams revalidate Sanofi Pastuer high dose formulation at 0.7 mL versus the traditional 0.5 mL. CPT code 90662 will be used to code this product. Ensure the CDM or billing crosswalks reflect the updated 0.7 mL per billed units or is based on a per dose and only 1 billed unit is calculated per dose.
Pharmacy and revenue integrity teams CPT 90686 and 90685 differ only by the dosage administered but often represent the same NDC. Validate that your system produces the correct CPT based on the dose administered and only 1 billed unit per. It may be helpful to apply a “dosing” rule that allows the CPT to alternate when a 0.25 mL vs. 0.5 mL dose is documented.