Last Updated: Feb 28, 2017
Effective Jan. 1, 2017, there were CPT code changes for both influenza vaccines and health risk assessments. Here's a quick look at what physicians and practices should know about the changes.
Influenza Vaccination Updates
Several influenza vaccination code descriptions have been revised to eliminate an age indicator and instead include dosage. To view the descriptions and find answers to FAQs, check out the Centers for Medicare and Medicaid Services article on immunization billing here.
As a reminder, Medicare covers one influenza vaccination per influenza season. Twelve months do not have to elapse per vaccination.
Health Risk Assessment Updates
Two new CPT codes for the administration of health risk assessments have been established to replace 99420:
- 96160—Administration of patient-focused health risk assessment instrument (e.g., health hazard appraisal) with scoring and documentation, per standardized instrument
- 96161—Administration of caregiver-focused health risk assessment instrument (e.g., depression inventory) for the benefit of the patient, with scoring and documentation, per standardized instrument.
This service may be billed in conjunction with an office visit. It must be administered and scored in a diagnostic setting. You may not bill 96160 separately when included with a Medicare Annual Wellness Visit, or a preventive service.
Keep in mind that, to bill 96161, the claim must be submitted using the patient's information and the assessment must be documented in the patient record.