Coding a 96372 with admin and E&M

[jeilers@co.slo.ca.us]

So just trying to get clarity on if we can code 96372 with an admin code 90471 and also with E&M code? Or do we have to code either the Admin code or the E&M Code (not both together) for the 96372? Thank you,

Jessy

 

[SharonCollachi]

90471 is for vax administration
96372 is for a subcu/IM injection (not a vax)

So did you two a vaccine adminstration as well as another injection? What was that other injection?

 

[jeilers@co.slo.ca.us]

No just the 96372 and an E&M, but there is some talk about how we should be adding a administration code as well. So that is where we are getting confused. Are we allowed to add an admin code also?

 

[SharonCollachi]

If you pull out a CPT book, you'll find the full description of 90471, which starts "Immunization administration..."

The 90471 is the administration code. What did they think the 90471 was for? You're billing the vaccine toxoids with their own code, so it's not that.

 

[jeilers@co.slo.ca.us]

Thank you, is there a separate admin code I can use?

 

[csperoni]

Now I'm getting confused.
96372 is a subq/IM injection (aka administration of a medication that is injected)
90471 is administration of a vaccine
What are you administering?
If it is a medication injected subq or IM, then 96372 along with the J code.
If it is a vaccine, then 90471 (or other appropriate vaccine admin code for the service provided) along with the vaccine.
You would only bill both 96372 and 90471 if the patient happened to get a vaccine and a medication injection the same day. I would imagine it's unusual, but certainly not impossible.

Perhaps this chart from AAP might help you clarify vaccine coding. https://www.aap.org/en-us/Documents/coding_vaccine_coding_table.pdf

 

[jeilers@co.slo.ca.us]

Thank you