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Correct CPT Codes for Pneumonia and Influenza Vaccines

Published on 

Wednesday, August 18, 2021

 | Coding 
 | FAQ 

I am a new chargemaster (CDM) coordinator at my facility, and my current to-do list involves trying to verify the CPT / HCPCS code assignment for vaccines. How can I determine if the CPT codes assigned in the CDM for pneumonia and influenza vaccines are correct?


Don’t try to figure it out on your own – you really need the expertise of one of your hospital pharmacists to help you with this. Fortunately, there are only 2 CPT codes to choose from for the pneumonia vaccines, but 20 CPT codes and 6 HCPCS Q codes to choose from for the influenza vaccines. In our experience with pharmacy CDM reviews, hospital pharmacists are usually able to easily tell you which CPT or HCPCS code should be used.

Article Author: Jeffery Gordon, RN, MSN, CCA, COC
Jeffery Gordon, RN, MSN, CCA, COC, is the Manager of Outpatient Medical Review at Medical Management Plus, Inc. Jeff has over thirty-five years of experience in healthcare including Critical Care, Infection Control, Quality Assurance, Medical Necessity, Outpatient Coding, Medicare Claims data analysis and Medical Record review.

This material was compiled to share information.  MMP, Inc. is not offering legal advice. Every reasonable effort has been taken to ensure the information is accurate and useful.