Anyone else experiencing this problem since Sept 2024 flu vaccine administration. Denial reason: inconsistent with patient age (when administered to patients less than 3 yrs old). Reached out Provider Relations and crickets for 1 month now. Sent case to AAP Pediatric Coding Hotline this morning as I am aware that this denial practice is not unique to us.
Yes we are. I have spoken with the flu reps and they are working with payers to get codes updated. It is taking forever. The 90661 was an old code they brought back to life. When it was originally setup Flucelvax was only good for 4 and up. Payers are taking way too long to update their systems.
Heard back from Provider relations representative after 5 week. They have known that it’s a problem w/o the help from practices or the vaccine manufacturer’s representatives. So why are they continuing to dray their feet? ($$$$). It really takes this long to “update” the claims’ system/software for annual influenza vaccines that were shipped in August for administration?!.