Family physicians face H1N1, fall flu

Coming into the fall flu season, family physicians faced a double threat—the normal challenges presented by the seasonal flu and the hysteria surrounding the H1N1 swine flu. As the Centers for Disease Control and Prevention, the Texas Department of State Health Services, and other entities have released information on vaccine development, administration, preventive measures and more, TAFP and AAFP have developed resources to keep members up to date on the flu situation.

Texas family physicians must first ensure they register to order the H1N1 flu vaccine. The U.S. government purchased 250 million doses of the vaccine and has begun distributing it through state health departments as it is available. Texas DSHS opened the provider registry in mid-August and began collecting physician information on staff size, estimated patients to vaccinate by population group, the number of seasonal flu vaccinations administered during 2008-2009, vaccine storage capacity and clinic operating hours.

Because vaccine availability was limited at first, DSHS and the CDC Advisory Committee on Immunization Practices recommend giving priority to five target groups, totaling approximately 159 million people nationwide: pregnant women, caregivers of children younger than 6 months of age, health care personnel, people aged 6 months to 24 years, and people aged 25 through 64 years considered high risk for influenza complications. Texas began receiving vaccine in mid-October.

There is no cost to physicians to obtain the vaccine and physicians may bill payers for vaccine administration. For Texas Medicaid beneficiaries, the Texas Medicaid & Healthcare Partnership instructs Texas physicians to include the pandemic flu vaccine procedure code 90663 on the claim and the appropriate vaccine administration code. For these codes and further instructions, call the TMHP Contact Center at (800) 925-9126 or go to www.tmhp.com.

AAFP launched a page on their website for H1N1 administration coding among the major payers—Humana, CIGNA, Aetna—as well as the National Drug Code numbers among the major manufacturers—Sanofi Pastuer, MedImmune, CSL, Novartis and GlaxoSmithKline. The AMA’s Current Procedural Terminology Editorial Panel approved code 90470 for H1N1 immunization administered through intramuscular or intranasal, including counseling when provided, according to AAFP. Go to the Practice Management section of www.aafp.org.

For more information on the vaccine, its availability and administration, go to the DSHS flu website, texasflu.org, or the CDC’s H1N1 website, www.cdc.gov/h1n1flu. As H1N1 news develops, TAFP will continue to keep members informed.