Internal Medicine Coding Alert

You Be the Coder:

Tetanus and Hepatitis A Vaccines

Published on Sun Jul 01, 2001

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Test your coding knowledge. Determine how you would code this situation before looking at the box below for the answer.

Question: How should I code for administering a tetanus or hepatitis A vaccine? I've been using 90471 and 90472 but receiving denials.

California Subscriber

Answer: Medicare no longer recognizes 90471 (immunization administration [includes percutaneous, intradermal, subcutaneous, intramuscular and jet injections and/or intranasal or oral administration]; one vaccine [single or combination vaccine/toxoid]) or 90472 (... each additional vaccine [single or combination vaccine/toxoid]), but may begin using them again in 2002. Until then, reporting two new HCPCS codes, G0190 (immunization administration; single vaccine) and G0191 (immunization administration; each additional vaccine), will provide payment for the administration of these injections.

HCFA created G0190 and G0191 to replace 90471 and 90472 because the description of the CPT codes included the phrase "intranasal or oral administration." The description of 90471 and 90472 will be changing in 2002 to reflect administration of vaccines by injection methods only. Two new codes (90473 and 90474) will be added to reflect the administration of vaccines by intranasal or oral route. Commercial carriers do not recognize HCPCS codes and may reimburse for vaccines using 90471 or 90472.

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