RSV, CPT, and Me: A New Vaccine for a Vulnerable Population

For years, infants and young children have been the focus each flu season when it comes to Respiratory Syncytial Virus (RSV). An estimated 58,000-80,000 children younger than five are hospitalized due to RSV infection each year in the United States alone. But there’s another vulnerable population experiencing significant numbers: people ages 60 years and older.

This fall, the CDC is endorsing the use of new RSV vaccines from GSK and Pfizer for this age group, which are the first licensed in the U.S. to protect against RSV. While RSV is one of the many colds people contract throughout their lives, it can cause life-threatening complications for older adults, the very young, and the immunocompromised.

There’s always a level of fear from the public with any new vaccine, but it’s advancements like this that strengthen our public health. Just think about polio or measles. We are much better off as a society with these vaccines in place to keep us as safe as possible. Although new vaccines might seem scary at first, the end results are worth it.

Flu season is in full swing, but the RSV vaccination helps keep us and our loved ones safe from a highly contagious virus. The CDC estimates RSV being the cause each year for 60,000-160,000 hospitalizations and 6,000-10,000 deaths among older adults.

Of course, with new vaccines comes new CPT codes. The AMA added five new codes (90380, 90381, 90683, 90679, and 90678) to provide better tracking and data analysis on specific RSV products. Utilizing these new codes, in addition to the previous RSV-related codes, ensures providers receive appropriate reimbursement and helps continue the advancement of innovation in health care.

A new vaccine is a benefit to our families and communities and now, as we love to say in the coding world, “there’s a code for that.”

Cindy Nicholas, VP Coding Solutions, AQuity Solutions

Cindy is a global healthcare leader with more than 35 years of experience in all aspects of revenue cycle management, patient experience and health information management. Specializing in medical coding, workflow design, quality improvement and healthcare compliance, her ability to develop and lead high performing teams is echoed in her passion for delivering top quality service and impactful results. A credentialed member of AHIMA, Cindy also holds certifications from both the Healthcare Compliance Association (HCCA) and National Association of Healthcare Quality (NAHQ).

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