Pediatric Coding Alert

Question:If we report the new 90460 and 90461 vaccine codes, must the physician perform the counseling in order to bill the codes, or can the medical assistants do some of the counseling as well? We will occasionally have patients return for missed shots and the medical assistants will be the ones to administer their shots, but we aren't sure whether we can bill these new codes if the physician doesn't perform the counseling.Virginia SubscriberAnswer:Both 90460 (Immunization administration through 18 years of age via any route of administration, with counseling by physician or other qualified health care professional; first vaccine/toxoid component) and +90461 (Immunization administration through 18 years of age via any route of administration, with counseling by physician or other qualified health care professional; each additional vaccine/toxoid component [List separately in addition to code for primary procedure]) state, "with counseling by physician or other qualified health care professional."The ultimate determination [...]