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Updated Age Restrictions to Influenza Vaccine Codes

March 6, 2019

Effective retroactively for dates of service on or after January 1, 2017, the age restrictions for CPT codes 90686 (influenza virus vaccine, quadrivalent (IIV4), split virus, preservative free, 0.5 ml dosage, for intramuscular use) and 90688 (influenza virus vaccine, quadrivalent (IIV4), split virus, 0.5 ml dosage, for intramuscular use) have been updated. The age range for both codes is now “0” through “99 years of age.”

An Erroneous Payment Correction (EPC) will be implemented to reprocess affected claims. No action is required of providers.