Wiki billing units

[xxjenn914xx]

I'm being told that when billing vaccines with multiple components like tetanus dipht. vaccine that I should be billing for 2 units. I'm billing the 90714 for the vaccine which describes both components. I was also told to bill both 90471 and 90472 for the admin because you bill for both comp. If it's only one vaccine why would you charge for admin 2?? help!!

 

[trugriff]

Vaccine Billing

I know vaccine billing can be frustrating. When billing a vaccine that has multiple components, it depends on whether or not the provider counseled on the vaccine as to how you report the vaccine admin codes. The vaccine CPT code you're referring to has 2 components, Tetanus and Diphtheria. If your provider counseled on the vaccine before administering it then you would report the vaccine admin code 90460 x1 unit and 90461 x1 unit. If your provider gave no counseling or it was a nurse visit only then you would report the vaccine admin as 90471 x1 unit. Here's a link that will tell you the components of vaccines. Plain language: if counseling is done by the provider use 90460 for the 1st component and 90461 for any additional components of a vaccine. No counseling done? Report 90471, 90472 etc.. for each vaccine given, and no components. Hope this helps

http://www.aap.org/en-us/profession...inistered_Pediatric_Vaccines_Coding_Table.pdf

 

[overnluv@yahoo.com]

Vaccine

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
90461 - each additional vaccine/toxoid component
(List separately in addition to code for primary procedure)
-There is no differentiation by route of administration
-Counseling may be provided by the physician or non-physician provider (if allowed under state scope of practice) and counseling must be documented in the medical record
-Use these codes through age 18
-90460 is reported for the first component of each vaccine administered whether it is a single or combination vaccine
-90461 is reported in addition to 90460 for each additional component in a given vaccine (“Component” refers to each antigen in a vaccine. Combination vaccines are those that contain multiple components (antigens), ie, MMRV.
-If vaccine counseling is not performed, report codes 90471-90474
-90471 – Immunization administration (including percutaneous, subcutaneous, intramuscular, or jet injections); one vaccine (single or combination vaccine/toxoid)
-90472 - each additional vaccine (single or combination vaccine/toxoid)
-90473 – Immunization administration by intranasal or oral route; one vaccine (single or combination vaccine/toxoid)
-90474 - each additional vaccine (single or combination vaccine/toxoid)

 

[insight]

Anyone getting reimbursed for E & M or Well Child when billing for vaccines. I have been using modifier 25 and we get paid some of the time.