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Billing of Influenza Vaccines for the 2018-2019 Influenza Season pdf

Connecticut Medicaid (HUSKY Health)·CT · Family Medicine, Internal Medicine, General Practice +1 more·Provider Bulletin
Effective date
Not stated
We identified it
Jun 20, 2026
Days to comply

Summary

Due to high claim denial rates, providers must ensure they use the correct HCPCS codes that match the 11-digit NDC numbers when billing influenza vaccines to Connecticut Medicaid. Three specific vaccine NDCs have been identified as having the highest denial rates due to improper code cross-walking.

Action Required

Action needed
Immediately: Billing team must verify that NDC numbers exactly match HCPCS codes for all influenza vaccine claims to Connecticut Medicaid. Use the provided resources to cross-walk vaccine NDCs to correct codes, focusing on the three high-denial vaccines: AFLURIA QUAD (NDC 33332-0418-10), FLUZONE HIGH-DOSE (NDC 49281-0403-65), and FLUARIX QUAD (NDC 58160-0898-52). Update billing system validation rules to prevent NDC/HCPCS mismatches. Claims with mismatched codes will be denied.