Seasonal Influenza Vaccine • H1N1 Precautions • Billing for Mid-level Providers

QUESTION: Where can we order the seasonal influenza vaccine? All of the distributors we normally order from are out of stock.
ANSWER: The National Influenza Vaccine Summit-sponsored website "Prevent Influenza Now" has an influenza vaccine availability tracking system (IVAST) that has been developed to address difficulties healthcare providers may experience when trying to determine which wholesale distributors or manufacturers have seasonal influenza vaccine in stock for sale or on order. The table is updated to reflect which manufacturers have the immunization available.

QUESTION: Where can we find template signs to advise patients of the precautions our office is taking to prevent the spread of H1N1?
ANSWER: The Centers for Disease Control and Prevention (CDC) has a section on infection control measures that may be implemented at the first point of contact with a potentially infected person. Visual alerts (in appropriate languages) instruct patients and persons who accompany them (e.g., family, friends) to inform healthcare personnel of symptoms of a respiratory infection when they first register for care and to practice respiratory hygiene/cough etiquette. Click here for additional H1N1 resources from SDCMS.

QUESTION: How do we bill for mid-level providers (nurse practitioners, physician assistants) when they work under a physician? Are there any specific modifiers that need to be used?
ANSWER: If the mid-level provider is providing services "incident to" the physician's professional services, then no additional codes are needed. The NPI number on the claim form will reflect which provider was providing the service. For example, the nurse practitioner's NPI number should be listed under the physician's NPI when the NP is providing "incident to" services. There are no additional modifiers or codes needed when billing. For further information on the definition of "incident to" services, consult CMA's ON-CALL document #0245, "Allied Heath Professional Relationships: Business Issues," available free to SDCMS-CMA members. Note: Answer provided by SDCMS endorsed partner CHMB Solutions. CHMB provides free coding assistance for SDCMS members. Email your coding question(s) to SDCMS at Coding@SDCMS.org.