Pediatric Coding Alert

Question: What is the proper way to bill for Prevnar-13? Our coding/billing staff is confused about whether it includes thirteen individual components for billing for vaccine administration.

Florida Subscriber

Answer: Prevnar-13 has only one component, (Pneumococcal), although it contains 13 antigens. Therefore, the most appropriate CPT code would be 90670 (Pneumococcal conjugate vaccine, 13 valent, for intramuscular use) for the vaccine, and 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) for the administration. You should link the vaccine and administration to V03.82 (Need for prophylactic vaccination and inoculation against streptococcus pneuumoniae [pneumococcus]).