Question Tetanus admin + Modifiers

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I have always added modifier 25 to the E/M charge (both professional and facility) when a vaccine is administered, and not needed an additional modifier on the admin charge (90471). We recently launched on Epic and it is editing for a modifier when we administer a tetanus shot. Did some regulation change specific to that? (it's not happening with flu or penumo vaccine). Or is my suspicion correct that the edit is false?
Thank you, Marjorie
 

Pam Brooks

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99214 is a column 2 code against the 90471 according to CCI edits. You can override with a -25 if it's separately identifiable and medically necessary. You shouldn't need an additional modifier on the vaccine code.
 
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Thank you Pam, that's what I thought. (I'm in NH - a fellow New Englander!)
Medicare has G codes for administration of flu, pneumo, and hepatitis. Is it possible there's now a G code for administration of tetanus?
I can't believe that would have come out without notice, but you never know.
 

rthomas@impcna.com

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Thank you Pam, that's what I thought. (I'm in NH - a fellow New Englander!)
Medicare has G codes for administration of flu, pneumo, and hepatitis. Is it possible there's now a G code for administration of tetanus?
I can't believe that would have come out without notice, but you never know.
Medicare has not come out with a G code for admin of tetanus. You may already know this but the only way a tetanus is covered by Medicare is if the patient has a laceration, open would, etc. An AT modifier needs to go on 90715 to indicate that tetanus was given due to an injury. As far as diagnosis goes you can use Z23, 90715 & 90471 both go with the injury codes.
 
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