AMA Fact Sheet On Reporting For H1N1 (October 2009)

Why This Topic Matters

It helps readers understand a time-sensitive CPT update that affected how H1N1-related vaccine services were reported and tracked on claims during the 2009 immunization campaign.

Article Sections

1. AMA/CPT update on H1N1 reporting

   Introduces the purpose of the fact sheet, the timing of the update, and the source of the guidance. It also notes that the information was subject to change.

2. New and revised CPT vaccine reporting guidance

   Summarizes the coding update tied to the H1N1 vaccination effort and explains that the article focuses on reporting and reimbursement support for immunization services. It identifies the affected CPT code set and the context for the change.

3. How to report administration of the H1N1 virus vaccine

   Addresses reporting of the H1N1 vaccine product together with vaccine administration services. It also discusses claim-form billing considerations for the product entry.

4. How to report provision of a seasonal flu virus vaccine product

   Lists seasonal influenza vaccine product reporting options discussed in the article. This section focuses on the product side of influenza vaccine coding.

5. How to report administration of the seasonal flu virus vaccine when provided at the same patient encounter as the initial H1N1 vaccine administration

   Covers same-visit reporting when more than one influenza vaccine administration is involved. It also notes the relationship between initial and additional administration codes and references modifier use.

6. How to report administration of the H1N1 vaccine on the same date as a routine visit (Evaluation and Management)

   Addresses reporting when the H1N1 vaccination occurs during a routine visit and mentions associated E/M reporting considerations. It also includes claim-form guidance related to vaccine product identification.

7. Exhibit 1. Sample Claim Form: Reporting National Drug Codes (NDC)

   Provides a claim-form illustration related to drug code reporting and references the supporting form instructions. It is presented as a visual example rather than as coding policy.

8. Table 1. National Drug Codes (NDC)

   Presents a table of vaccine-related National Drug Codes associated with manufacturers and packaging formats. The table is included as a reference list for product identification.