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  #1  
Old 01-23-2008, 03:39 PM
jstrickler jstrickler is offline
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Smile injection codes

Can someone give me some guidance on the injection code to use with the Gardasil shot & Depo Provera shot. Some of the billers I work with say it should be a 90772 others say 90471 and still one more thinks code with a nurse visit 99211 only.....any input would be appreciated. Thank you!

Jen, CPC
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Old 01-23-2008, 09:05 PM
MarieCoderII MarieCoderII is offline
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Smile injection codes

Quote:
Originally Posted by jstrickler View Post
Can someone give me some guidance on the injection code to use with the Gardasil shot & Depo Provera shot. Some of the billers I work with say it should be a 90772 others say 90471 and still one more thinks code with a nurse visit 99211 only.....any input would be appreciated. Thank you!

Jen, CPC

Injection IM/SQ cpt code 90772 is the code to use following the "incident to" rule...with direct physician supervision and this is based on AMA CPT guideline. Without the presence of a physician, 99211 may be used instead. However, for Medicare, without direct physician supervision, neither one (90772 nor 99211) may be used...
Marie L., CPC
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  #3  
Old 01-28-2008, 07:31 PM
karilynn karilynn is offline
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Gardasil is a vaccine which would require the use of the 90471 code just like any other immunization. Depo is therapeutic so it would require 90772.
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Old 01-29-2008, 03:46 PM
rebecca lopez rebecca lopez is offline
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Default Gardisil

This is how I would code and I tell out check out staff.
Gardisil if the pt sees the MD the MD counsels and oders the gardisil the Nurse gives the injections. then I would code the E/M level new or estb code. with modifer 25. Then the gardisil 90649 with DX V04.89 and the 90772.

If the pt comes back and the nurse gives the injection then I would code the 90649 with 90741. If the nurse has enough documentation for the E/M (There are some guidelines for the nurse visit) and the md is on site you could also code a 99211 .
Hope this helps.
Rebecca Lopez CPC
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Old 02-08-2008, 02:40 PM
mcpalmeter mcpalmeter is offline
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Default Gardisil and Depo Provera

Jen,

The vaccine code for Gardasil is 90649. Gardasil vaccinates against the human papilloma virus. According to the FDA, the vaccine is approved for use in females 9-26 years of age.

As far as the administration code, use 90471.

Depo Provera can be used as a contraceptive measure or can be used as a therapeutic measure for things like ovarian cysts. Anyway, code the administration of the Depo Provera with 90772 as it is not a vaccine or a toxoid.

Maryann Palmeter, CPC
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Old 03-08-2009, 08:32 AM
robreed840 robreed840 is offline
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Wink

code 90772 is a deleted code for 2009. CPT states to report: use 96372.
Also if billing Illinois Public aide you need the " SL" modifier on 90649 (Gardasil)
When given by the nurse and ordered by the Dr in the office we bill
90649 SL ( if insurance is IDPA)
99211-25
Other insurance: 90649 Gardasil , 90471 administration


Robin Reed, CPC
robreed117@aol.com

Last edited by robreed840; 03-08-2009 at 08:46 AM.
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Old 03-08-2009, 09:15 PM
nurseauditor nurseauditor is offline
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Quote:
Originally Posted by robreed840 View Post
code 90772 is a deleted code for 2009. CPT states to report: use 96372.
Also if billing Illinois Public aide you need the " SL" modifier on 90649 (Gardasil)
When given by the nurse and ordered by the Dr in the office we bill
90649 SL ( if insurance is IDPA)
99211-25
Other insurance: 90649 Gardasil , 90471 administration


Robin Reed, CPC
robreed117@aol.com
This scenerio was for 2008...actually 1-23-08
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Old 01-02-2013, 12:56 PM
scurtis68 scurtis68 is offline
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Hello Jen,

For Depo and Gardasil I uses 96372
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