Medical Policy Revision: Intranasal Influenza Virus Vaccine (FluMist)

Based on a recent revision to our medical policy, Intranasal Influenza Virus Vaccine (FluMist), this vaccine will not be considered medically necessary for the 2017 to 2018 flu season.

This change was made in response to a June 21, 2017 Centers for Disease Control and Prevention (CDC) Advisory Committee on Immunization Practices (ACIP) decision. The CDC ACIP does not recommend FluMist for the 2017 to 2018 flu season due to reduced efficacy with this vaccine.

We encourage you to review this revised policy in our Medical Policy Manual.

Based on the guidelines of our revised medical policy, Intranasal Influenza Virus Vaccine (FluMist), procedure code 90660 included on claims for services provided on and after July 1, 2017 will be denied as not medically necessary regardless of the submitted diagnosis code(s).

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