The Medicare Monthly Review, MMR-2011-01, January 2011 - CGS

CodePayment LimitQ4027 $17.23Q4028 $53.78Q4029 $26.34Q4030 $69.33Q4031 $13.17Q4032 $34.66Additional InformationThe official instruction, CR 7225 issued to your carrier, FI, A/B MAC, and DME/MAC regarding thischange may be viewed at http://www.cms.gov/Transmittals/downloads/R2100CP.pdf on the CMS Website.If you have any questions, please contact your carrier, FI, A/B MAC, or DME MAC at their toll-freenumber, which may be found athttp://www.cms.gov/MLNProducts/downloads/CallCenterTollNumDirectory.zip on the CMS Web site.DisclaimerThis article was prepared as a service to the public and is not intended to grant rights or impose obligations. This article may contain references or links tostatutes, regulations, or other policy materials. The information provided is only intended to be a general summary. It is not intended to take the place of eitherthe written law or regulations. We encourage readers to review the specific statutes, regulations and other interpretive materials for a full and accurate statementof their contents. CPT only copyright 2009 American Medical Association.New HCPCS Q-codes for 2010-2011 Seasonal Influenza VaccinesMLN Matters® Number: MM7234 Revised (3)Related Change Request (CR): 7234Related CR Release Date: November 19, 2010Effective Date: October 1, 2010 unless otherwise specifiedRelated CR Transmittal #: R815OTNImplementation Date: January 3, 2011Note: This article was revised on December 9, 2010, to correct the short descriptor for code Q2039 on page2. All other information is the same.Provider Types AffectedThis article is for physicians and providers submitting claims to Medicare contractors (carriers, fiscalintermediaries [FIs], and/or Part A/B Medicare administrative contractors [A/B MACs]) for influenzavaccines provided to Medicare beneficiaries.Provider Action NeededThe article is based on Change Request (CR) 7234 which establishes separate billing codes for each brandnameinfluenza vaccine product under common procedure terminology (CPT) code 90658 and describesthe process for updating the new specific Healthcare Common Procedure Coding System (HCPCS) codesand their payment allowances for Medicare during the 2010-2011 influenza season.BackgroundCMS has created specific HCPCS codes and payment allowances to replace CPT code 90658 for Medicarebilling purposes for the 2010-2011 influenza season.CPT codes and descriptors are only copyright 2010 American Medical Association (or such other date publication of CPT)The Medicare Monthly Review 61 MMR 2011-01, January 2011