• 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 Tetanus j code?

Create Wiki
P

Pillow1

Guru
Messages
124
Location
Port Saint Lucie, FL
Best answers
0
For a medicare patient i billed 90718 and 90471 / vo6.5
but it was denied as a co 96 non covered item...
Is this a benefit that only covered once?
Any feedback is appreciated.
Thanks :)
 
Tetanus is only covered when related to an injury

Tetanus and Tetanus/Diphtheria Toxoids (90702, 90703, 90714, and 90718)
When filing claims for 90702, 90703, 90714, or 90718, the primary diagnosis should be one of the ICD-9 "V" codes indicating the need for prophylactic vaccination against bacterial diseases or combinations of diseases (V03.7 Tetanus toxoid alone or V06.5 tetanus-diphtheria) plus an injury related ICD-9 code as the secondary diagnosis. Tetanus or tetanus-diphtheria (Td) toxoids adsorbed are only covered when directly related to the treatment of an injury/wound. For further instructions, please visit the Centers for Medicare Medicaid Services website to view the Internet Only Manuals (IOM) – Medicare Benefit Policy Manual (Pub 100-2, Chapter 15, Section 50.4.4.2 - Immunizations

http://www.cms.gov/manuals/Downloads/bp102c15.pdf
 
RebeccaWoodward* said:
Tetanus is only covered when related to an injury

Tetanus and Tetanus/Diphtheria Toxoids (90702, 90703, 90714, and 90718)
When filing claims for 90702, 90703, 90714, or 90718, the primary diagnosis should be one of the ICD-9 "V" codes indicating the need for prophylactic vaccination against bacterial diseases or combinations of diseases (V03.7 Tetanus toxoid alone or V06.5 tetanus-diphtheria) plus an injury related ICD-9 code as the secondary diagnosis. Tetanus or tetanus-diphtheria (Td) toxoids adsorbed are only covered when directly related to the treatment of an injury/wound. For further instructions, please visit the Centers for Medicare Medicaid Services website to view the Internet Only Manuals (IOM) – Medicare Benefit Policy Manual (Pub 100-2, Chapter 15, Section 50.4.4.2 - Immunizations

http://www.cms.gov/manuals/Downloads/bp102c15.pdf
Click to expand...

Rebecca,

When I reference the Medicare Manual, all it says is that vaccines (except for the flu, pneumonia, and Hep B vaccines) are only covered if administered for treatment of an injury or exposure to disease. Where does it say that the V code has to be first and an open wound code as secondary. Can you point me to your source for this info or is this a local carrier guidance?
 
You must log in or register to reply here.
Top