vaccine combo not valid? 90471, 90746

Orthocoderpgu

True Blue
Messages
1,032
Location
Salt Lake City, UT
Best answers
1
90471 is for the admin of a vaccine. 90746 is for a vaccine. I'm starting to see insurance companies denying 90471 stating it's the wrong code. The only other codes for vaccine admins is one for counseling a patient and the other for an intranasal vaccine. There does not seem to be any other code to chose from. Is anyone else having this problem?
 

LOVE2CODE

Expert
Messages
392
Location
Alexandria, VA
Best answers
0
90471 is for the admin of a vaccine. 90746 is for a vaccine. I'm starting to see insurance companies denying 90471 stating it's the wrong code. The only other codes for vaccine admins is one for counseling a patient and the other for an intranasal vaccine. There does not seem to be any other code to chose from. Is anyone else having this problem?
Depends on the Insurance Company- Medicare uses G0010- If your ins co's are denying ask if they want the 'G' code submitted.

Hope this info helps.... :)
 

MarcusM

Expert
Messages
467
Location
Austin, Texas
Best answers
0
http://publichealth.lacounty.gov/ip/providers/AAP2011vaccinecodingchanges.pdf has some good information. Your payer is probably looking for the age specific vaccine admin CPT like:
CPT 90460 Immunization administration through 18 years of age via any route of administration, with
counseling by physician or other qualified health care professional; first vaccine/toxoid component
90461
each additional vaccine/toxoid component
(List separately in addition to code for primary procedure.)
 
Top