Internal Medicine Coding Alert

Published on Fri Sep 01, 2000 PDF

Question: Our practice treats some patients with hepatitis B and C. One of our physicians recently read that administering a dose of hepatitis A vaccine could enhance the treatment of these patients. Can we be reimbursed for giving these immunizations? What CPT codes would we use to report them? Tennessee Subscriber Answer: You may want to contact your commercial payers before you begin this treatment to find out what their policies are regarding the use of the vaccine. For a commercial payer that will cover such a claim, the appropriate codes to use would be 90471 (immunization administration [includes percutaneous, intradermal, subcutaneous, intramuscular and jet injections and/or intranasal or oral administration]; one vaccine [single or combination vaccine/toxoid]) to report the administration of the vaccine and 90632 (hepatitis A vaccine, adult dosage, for intramuscular use) for the vaccine itself. Although there are exceptions to this policy, Medicare generally does not cover vaccinations. There is no HCPCS code for the hepatitis A vaccination like there is for the influenza, hepatitis B and pneumococcal pneumonia vaccinations the agency does cover. You may want to have your hepatitis patients sign a waiver before you give them this vaccine. The waiver would state that the patient understands that this is a noncovered service and agrees to assume financial responsibility for the injection.