AMA updates avian influenza CPT code set

The American Medical Association (AMA) recently updated the Current Procedural Terminology (CPT©) code set for avian influenza, commonly known as bird flu. The update includes the following newly assigned provisional CPT product code for vaccines to protect patients against the H5N8 strain of the bird flu:

• 90695: Influenza virus vaccine, H5N8, derived from cell cultures, adjuvanted for intramuscular use

The H5N8 vaccine candidates have not yet received emergency use authorization from the FDA, but the AMA is updating the code set now to ensure EHRs are prepared. The new CPT code should be used with one of the following administration codes:

• 90460: Immunization administration through 18 years of age via any route of administration, with counseling by physician or other qualified health care professional; first or only component of each vaccine or toxoid administered
• 90461: Immunization administration through 18 years of age via any route of administration, with counseling by physician or other qualified health care professional; each additional vaccine or toxoid component administered
• 90471: Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections); one vaccine (single or combination vaccine/toxoid)
• 90472: Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections); each additional vaccine (single or combination vaccine/toxoid)

The CDC has reported 11 total cases of bird flu across three states in the U.S. since 2022, several in this month alone. Four and seven instances were caused by exposure to dairy cows and poultry, respectively.

Revenue integrity professionals can view the AMA’s guidance on bird flu coding and billing for more information.

Editor’s note: Find more NAHRI resources on vaccine coding and billing here.