BCBS & 90461

[kstine713]

Hello,

Are any Pediatric offices being reimbursed by BCBS for CPT code 90461 (each additional component of a vaccine?) If yes, in which state are you located?

Thank you!
Kaytie

 

[kathrynw]

Hi,
I would contact BCBS and get a copy of their reimbursement policy for immunizations/vaccines. This should help in determining what might be missing to properly report 90461.
These articles might be helpful.
https://www.aafp.org/practice-management/payment/coding/admin.html

https://www.aapc.com/blog/44909-same-day-immunization-administration-and-e-m/

https://www.aapc.com/blog/40074-words-of-wisdom-for-pediatric-preventive-care-claims/

 

[ebruton]

Are you using 90460 first since 90461 is an add on?

 

[rthomas@impcna.com]

Mississippi, and yes we get reimbursed. Are you billing with the correct number of units? for example MMR has a total of 3 components so we bill 90707, 90460 w/1 unit , 90461 with 2 units

 

[istanstu]

Not by our SC BCBS sometimes out of state BCBSs it's in our local policy not to.