Report State-Supplied Vaccines With This Modifier
Question: Our practice regularly administers vaccines, which are supplied by the state. Do I report the vaccine administration even though we aren’t charging the payer for the vaccine itself? AAPC Forum Participant Answer: You should check each patient’s payer’s respective policies, but generally, you would report what services are documented, including the appropriate CPT® code for any documented vaccine, and then append the vaccine code with modifier SL (State supplied vaccine). According to >Blue Cross Blue Shield of North Dakota, for example, you should submit the procedure codes for the vaccine and vaccine administration on the same claim, with the modifier SL appended for the vaccine and a charge of $0, and the appropriate CPT® code for the administration of a state-issued vaccine. If the patient also received a vaccine not supplied by the state, you’d report that vaccine and vaccine administration with the appropriate CPT® codes on the same claim. Rachel Dorrell, MA, MS, CPC-A, CPPM, Production Editor, AAPC
