Pharmacy Question for the Week of May 1, 2017


According to the American Medical Association (AMA), the following code took effect on January 1, 2017: 90682—influenza virus vaccine, quadrivalent (RIV4), derived from recombinant DNA, hemagglutinin (HA) protein only, preservative and antibiotic free, for intramuscular use. However, our MAC has denied claims for this code. Does Medicare not accept this new code?


According to the Centers for Medicare & Medicaid Services (CMS), claims with dates of service (DOS) on or after July 1, 2017 will be paid for influenza virus code 90682. Contractors shall deny claims submitted with code 90682 for DOS between January 1, 2017 and June 30, 2017. For details of this policy, go to transmittal R3754CP at

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