Name of Manual - Blue Cross and Blue Shield of Minnesota

Coding Policies and Guidelines (Medical Services)
Immunizations
(continued)
11-28
*Centers for Disease Control and Prevention (CDC) considers the
VFC administration reimbursement amount to be paid on a per
injection basis, not a per component basis.
DHS website reference
To view the DHS specific information go to the following link:
http://www.dhs.state.mn.us/main/idcplg?IdcService=GET_DY
NAMIC_CONVERSION&RevisionSelectionMethod=LatestRe
leased&Redirected=true&dDocName=id_000094
Members impacted
This applies to members enrolled in the following Blue Plus plans:
Product name Group numbers
Blue Advantage (PMAP) 18
years and younger
MinnesotaCare 18 years and
younger
PP021, PP022, PP024, PP025,
PP026, PP027, PP031, PP032,
PP034, PP035, PP036, PP037
PP111, PP112, PP151, PP152
Supplies Used in Conjunction with Immunization
Administrations
Syringes, needles or other supplies (A4206-A4209) used in
conjunction with administering any injection, including
immunizations, are considered integral to that administration and
will be denied as incidental to the administration.
Flu Vaccines
The influenza vaccine codes Q2035-Q2039 were added for
Medicare to identify specific flu vaccine products. Additionally,
Medicare instructed that the existing CPT vaccine code 90658
would no longer be allowed. While our Medicare Advantage plan
will follow Medicare’s requirements, commercial plans will
continue to accept 90658 as well as the new flu vaccine codes.
However, edits will be instituted.
Only one flu vaccine code will be accepted: 90658, Q2035,
Q2036, Q2037, or Q2038. Code Q2039 should not be submitted.
If the vaccine is not specific to the products noted in codes Q2035-
Q2038, Blue Cross expects the code 90658 to be submitted in lieu
of the unlisted code Q2039. As a general policy, claims may be
subject to denial when an unlisted code is submitted when a
definitive code exists. Such would be the case for code Q2039.
Blue Cross and Blue Shield of Minnesota Provider Policy and Procedure Manual (06/20/12)