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Important H1N1 (Swine Flu) Information

As the H1N1 (swine flu) outbreak grows in our region, the United States, and internationally, we are working with the New Jersey Department of Health and Senior Services to provide assistance with recognizing and reporting cases of swine flu.

Temporary claims payment policy change

Rapid influenza diagnostic tests can help in the diagnosis and management of patients with signs and symptoms compatible with H1N1 (swine-origin) influenza A. For this reason, effective April 27, 2009, we have added the CPT^® codes 87804 and 87400 to Policy #00.01.41: STAT Laboratory Tests Performed in the Outpatient Hospital Setting for Health Maintenance Organization (HMO) and Point of Service (POS) products.

For temporary billing changes regarding rapid influenza testing, see Bulletin 03-09.

New Jersey Facilities

Pennsylvania/Delaware Facilities

Professional Providers

Until further notice, office-based rapid influenza testing (CPT^® 87804) is currently allowed as an HMO/POS billabove. There are no changes for PPO members.

Laboratory testing (CPT^® 87400) is currently also available for HMO/POS members at capitated laboratories and for PPO members at any participating network laboratory that performs that test.

Resources

The Centers for Disease Control and Prevention: www.cdc.gov/swineflu
The New Jersey Department of Health and Senior Services: www.state.nj.us/health/

Additional information about influenza