Coding For Vaccines & Administration

Rperry

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Good Afternoon Subject Matter Experts,

The following is an accurate statement:

CPT Coding of Vaccines and Administration
Physicians may report the administration of vaccines using codes 90465-90474. The vaccine product is separately reportable using codes 90476-90749.

Administration codes 90465-90468 are reported only when the physician provides face-to-face counseling to a patient/family during the administration of a vaccine to a patient younger than 8 years of age. For administration of any vaccine that is not accompanied by face-to-face physician counseling to the patient/family or provided to a patient 8 years of age or older, report codes 90471-90474.

When reporting multiple vaccine administrations on the same date, note that only one first order administration code should be reported. For instance, when reporting two vaccines administered by injection to a child under 8 years of age with physician counseling, code 90465 is reported for the first vaccine administration and code 90466 is reported for the additional vaccine administration. Were the second vaccine administration by oral or intranasal route, code 90468 could be reported in addition to code 90465.

Therefore the physician should not used CPT code 90465 if face-to-face counseling to a patient/family during the administration of a vaccine take places
 

Biller385

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If the doctor counsels face to face for the vaccines use 90465 for the first vaccine and 90466 for the second etc. If an oral vaccine is included in the series of vaccines use 90468. If there was not counseling use 90471 for the first and 90472 for the second vaccine, etc. If an oral vaccine is included in the series of vaccine use 90474.
 
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