Pediatric Coding Alert

Question: A 5-year-old patient came with Mom to receive MMR [measles, mumps, and rubella] and DTaP [diphtheria, tetanus, and pertussis] vaccinations. The pediatrician administered both along with counseling. Then, as Mom and patient were leaving the office, we realized that the patient also needed a Hepatitis B shot, so we called the patient back in and a medical assistant administered the Hep B. How do we code this?

Illinois Subscriber

Answer: Assuming the vaccine codes below are the vaccines your pediatrician and assistant administered, your bill would look something like this:

For the MMR: Code 90707 (Measles, mumps and rubella virus vaccine (MMR), live, for subcutaneous use) with one unit of 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) and two units of +90461 (… each additional vaccine or toxoid component administered (List separately in addition to code for primary procedure), as your pediatrician administered three vaccines and counseled the patient/parent on the vaccine.

For the DTaP: Code one unit of 90460 and two units of +90461 again for the vaccine administration and counseling and 90700 (Diphtheria, tetanus toxoids, and acellular pertussis vaccine (DTaP), when administered to individuals younger than 7 years, for intramuscular use) for the vaccine.

For the Hep B: Code 90471 (Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections); 1 vaccine (single or combination vaccine/toxoid)) for the vaccine administration without counseling and 90744 (Hepatitis B vaccine (HepB), pediatric/adolescent dosage, 3 dose schedule, for intramuscular use) for the Hep B vaccine.