What is the difference between CPT code 90460 and 90461?
Code 90460 is reported once for the first component of each vaccine or toxoid administered by any route. The reporting of code 90460 includes counseling for the first vaccine component. Code 90461 is additionally reported for the counseling associated with each additional component of any combination vaccine or toxoid.
What is the difference between CPT code 90460 and 90471?
The 90460 code is used when a physician is present and performs face-to-face counseling to the caregiver or parent. This code can only be used for patients through age 18. Code 90471 is used when the drug is administrated by a medical assistant or nurse and the patient does not see the physician at all.
How many units of 90460 can you bill?
Bill 1 unit of 90460 and 4 units of 90461. If the patient is 19 years of age or over, or if they are 18 years of age or under and counseling was not performed, use the code set that is based on number of injections administered at that visit (90471–90472).
What is the CPT code for administration of MMR vaccine?
90707 Measles, mumps, and rubella vaccine (MMR), live, for subcutaneous use.
Can 90460 be billed twice?
You can not code more than one 90460 per DOS.
What is the correct CPT code for flu vaccine?
Vaccine CPT Code to ReportCPT Code Description90688Influenza virus vaccine, quadrivalent (IIV4), split virus, 0.5 mL dosage, for intramuscular use90756Influenza virus vaccine, quadrivalent (ccIIV4), derived from cell cultures, subunit, antibiotic free, 0.5 mL dosage, for intramuscular use4 more rows•Aug 31, 2021
Is CPT 90461 covered by Medicaid?
The federal rule does not allow for reimbursement of procedure code CPT 90461. Medicaid will not reimburse procedure codes CPT 90473 and CPT 90474 at this time, as no Medicaid covered vaccines for recipients ages 19-20 are administered via the intranasal or oral route.
What is the CPT code for Tdap vaccine for adults?
Medical providers who “buy and bill” for the Tdap vaccine should use the Current Procedural Terminology (CPT) code 90715. For administration of the vaccine, providers should bill CPT code 90471 or 90472, as appropriate.
What is the ICD 10 code for MMR?
B05. 9 is a billable/specific ICD-10-CM code that can be used to indicate a diagnosis for reimbursement purposes. The 2022 edition of ICD-10-CM B05.
Can 90460 and 90473 be billed together?
Note that code 90471 or 90473 cannot be reported in conjunction with 90460. Therefore, if during a single encounter, a patient receives multiple vaccines and there is counseling on all but the influenza vaccine, report 90472 or 90474 in addition to 90460 and 90461 as appropriate.
Reporting Administration Per Component
- The pediatric immunization administration with counseling codes are: 1. 90460: Immunization administration through 18 years of age via any route of administration, with counseling by physician or other qualified health care professional; first or only component of each vaccine or toxoid administered 2. +90461: Each additional vaccine/toxoid compone...
Items of Note About Codes 90460 and 90461
- To correctly report vaccine counseling and administration with these codes, it is important to recognize what the codes do and do not include. 1. These codes are limited to immunization administration, meaning purchased vaccine products must be separately reported. 2. A face-to-face service where a physician or other qualified health care professional (qualified per state lic…
Administration Coding Example
- An 11-year old girl presents for a preventive visit (99393). In addition, the child and her mother are counseled by the physician on risks and benefits of HPV (90649), Tdap (90715) and seasonal influenza (90660) vaccines. The physician documents the discussion. The mother signs consent to administration of these vaccines. A nurse prepares and administers each vaccine, completes …