• If this is your first visit, be sure to check out the FAQ & read the forum rules. To view all forums, post or create a new thread, you must be an AAPC Member. If you are a member and have already registered for member area and forum access, you can log in by clicking here. If you've forgotten the password it can be reset on our sign in section by entering your registered Email Address or Username here. To start viewing messages, select the forum that you want to visit from the selection below..

Wiki Immunization billing question

Create Wiki
C

cecilia73

Guest
Messages
19
Location
fort walton beach, FL
Best answers
0
Hey everyone,

I am new to pediatric billing and Im a bit confused on a coding issue. I know to use 90460-90461 for admin under 18 with face to face counseling. And to use 90471- 90472 is pt is over 18yrs and no counseling.

Question is what admin code would I use if the patient is under 18yrs and there was no counseling offered, the MD. gave the shot but no counseling.

Help thank you!:)
 
cecilia73 said:
hey everyone,

i am new to pediatric billing and im a bit confused on a coding issue. I know to use 90460-90461 for admin under 18 with face to face counseling. And to use 90471- 90472 is pt is over 18yrs and no counseling.

Question is what admin code would i use if the patient is under 18yrs and there was no counseling offered, the md. Gave the shot but no counseling.

Help thank you!:)
Click to expand...

90471-90472

;)
 
Thanks Brandi,

So the codes 90471-90472 are also used for patients under the age of 18, if Im understanding this correctly. The description the ICD 9 gives only states above 18yrs old. Thank you for helping me out on this I was going nuts trying to figure out another code.
 
cecilia73 said:
Thanks Brandi,

So the codes 90471-90472 are also used for patients under the age of 18, if Im understanding this correctly. The description the ICD 9 gives only states above 18yrs old. Thank you for helping me out on this I was going nuts trying to figure out another code.
Click to expand...

Yes, that's correct. The guidelines (in green) on page 458 of the CPT instruct you to use 90471-90474, for patients who are over 18, or when no counseling is provided with pediatric patients. Hope that helps! ;)
 
Yes it does you are a life saver. Now I have one other question. I am trying to bill code 90657 where can I find a list of # of components this vaccine and others have so I can make sure I am billing the correct # . Thanks again Brandi
 
cecilia73 said:
Yes it does you are a life saver. Now I have one other question. I am trying to bill code 90657 where can I find a list of # of components this vaccine and others have so I can make sure I am billing the correct # . Thanks again Brandi
Click to expand...

I'm not sure if there is an official list, but if I had to guess, I'd say that the AAP (American Academy of Pediatrics) would most likely have it. 90657 has 1 component - meaning, it only vaccinates against one disease. Ignore the # of valents listed in the code descriptions, and just count the diseases (like those listed under 90669 & 90670). The ones you have to watch out for are MMR (3 components), MMRV (4 components), DTaP (3 components), and 90698 (5 components - DTap, Hib, & polio)...Make sense?
 
You must log in or register to reply here.
Top