Wiki Tetanus Help

[tcoder5]

It is my understanding that Medicare does not cover tetanus shots unless it is due to injury. Does anyone have any additional information on this?

If it is due to injury is it correct to code 90703 with an injury dx? What would the admin code be (90471)?

Any help would be appreciated.

 

[mattern10]

I think if you use that admin code will not get covered by medicare but secondary will usually pick up especially if it is mass health. Have the md rx it to the pharmacy then you only have to worry about the inject.

 

[CBaer]

Don't forget to use the modifier "AT" acute treatment

Tetanus Vaccine (Novitas Solutions Bulletin)

Issued: March 21, 2013

To report the tetanus vaccine administered for the treatment of an injury or direct exposure to a disease or condition, append modifier AT (acute treatment) to the code for the vaccine. Claims submitted without modifier AT will be denied.

Note: The medical record must support the need for the service and the use of modifier AT.

Vaccinations or inoculations are excluded as immunizations unless they are directly related to the treatment of an injury or direct exposure to a disease or condition, such as anti-rabies treatment, tetanus antitoxin or booster vaccine, botulin antitoxin, antivenin sera, or immune globulin. In the absence of injury or direct exposure, preventive immunization is not covered. However, pneumococcal, hepatitis B, and influenza virus vaccines are exceptions to this rule.

Cheryl

 

[tcoder5]

Thanks for the help.

 

[fradknot]

I was under the impression that the "at" modifier is for chiropractic claims only? Did i miss something?

 

[Lynda Wetter]

I was under the impression that the "at" modifier is for chiropractic claims only? Did i miss something?

Novitas, the medicare provider in the MD, PA area requires the use of the AT modifier for tetanus shot when it is provided as non-routine.
Also the admin code is bundled into E/M codes so you may need a mod there too.