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Thread: injection codes

  1. #1

    Smile injection codes

    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

  2. #2
    Join Date
    Apr 2007
    Location
    San Diego
    Posts
    17

    Smile injection codes

    Quote Originally Posted by jstrickler View Post
    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 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

  3. #3

    Default

    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.

  4. #4
    Join Date
    Apr 2007
    Location
    San Gabriel Valley
    Posts
    30

    Default 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

  5. #5
    Join Date
    Apr 2007
    Location
    Jacksonville, Florida - 90417
    Posts
    161

    Default 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

  6. #6

    Wink

    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 by robreed840; 03-08-2009 at 08:46 AM.

  7. #7

    Default

    Quote Originally Posted by robreed840 View Post
    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
    This scenerio was for 2008...actually 1-23-08

  8. #8

    Default

    Hello Jen,

    For Depo and Gardasil I uses 96372

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