Wiki injection codes - Can someone give me

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jstrickler

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Can someone give me some guidance on the injection code to use with the Gardasil shot & Depo Provera shot. Some of the billers I work with say it should be a 90772 others say 90471 and still one more thinks code with a nurse visit 99211 only.....any input would be appreciated. Thank you!

Jen, CPC
 
injection codes

jstrickler said:
Can someone give me some guidance on the injection code to use with the Gardasil shot & Depo Provera shot. Some of the billers I work with say it should be a 90772 others say 90471 and still one more thinks code with a nurse visit 99211 only.....any input would be appreciated. Thank you!

Jen, CPC
Click to expand...


Injection IM/SQ cpt code 90772 is the code to use following the "incident to" rule...with direct physician supervision and this is based on AMA CPT guideline. Without the presence of a physician, 99211 may be used instead. However, for Medicare, without direct physician supervision, neither one (90772 nor 99211) may be used...
Marie L., CPC:)
 
Gardasil is a vaccine which would require the use of the 90471 code just like any other immunization. Depo is therapeutic so it would require 90772.
 
Gardisil

This is how I would code and I tell out check out staff.
Gardisil if the pt sees the MD the MD counsels and oders the gardisil the Nurse gives the injections. then I would code the E/M level new or estb code. with modifer 25. Then the gardisil 90649 with DX V04.89 and the 90772.

If the pt comes back and the nurse gives the injection then I would code the 90649 with 90741. If the nurse has enough documentation for the E/M (There are some guidelines for the nurse visit) and the md is on site you could also code a 99211 .
Hope this helps.
Rebecca Lopez CPC
 
Gardisil and Depo Provera

Jen,

The vaccine code for Gardasil is 90649. Gardasil vaccinates against the human papilloma virus. According to the FDA, the vaccine is approved for use in females 9-26 years of age.

As far as the administration code, use 90471.

Depo Provera can be used as a contraceptive measure or can be used as a therapeutic measure for things like ovarian cysts. Anyway, code the administration of the Depo Provera with 90772 as it is not a vaccine or a toxoid.

Maryann Palmeter, CPC
 
code 90772 is a deleted code for 2009. CPT states to report: use 96372.
Also if billing Illinois Public aide you need the " SL" modifier on 90649 (Gardasil)
When given by the nurse and ordered by the Dr in the office we bill
90649 SL ( if insurance is IDPA)
99211-25
Other insurance: 90649 Gardasil , 90471 administration


Robin Reed, CPC
robreed117@aol.com
 
Last edited:
robreed840 said:
code 90772 is a deleted code for 2009. CPT states to report: use 96372.
Also if billing Illinois Public aide you need the " SL" modifier on 90649 (Gardasil)
When given by the nurse and ordered by the Dr in the office we bill
90649 SL ( if insurance is IDPA)
99211-25
Other insurance: 90649 Gardasil , 90471 administration


Robin Reed, CPC
robreed117@aol.com
Click to expand...
This scenerio was for 2008...actually 1-23-08
 
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