Results 1 to 4 of 4

90472 additional immun inj

  1. Default 90472 additional immun inj
    Medical Coding Books
    I am not sure if I am reading this procedure correctly. If an addtional immunization is needed we are to code 90472. The question is if the pt receives 3 immun inj are we to code 90471, 90472 x2 or x1? Can this procedure 90472 be used more than once or are all the addtional immun inj included in this one procedure 90472.

  2. #2

    90472 is billed for EACH additional immunization administered. For example, say there were a total of 4 immunizations given, you would bill:

    90471 X1 unit
    90472, X3 units

    Hope that makes sense!
    Sylvia Thompson, CPC
    Billing Supervisor
    San Diego, CA

  3. Default
    Thanks, it does make since. We have been billing each imun inj but for some reason we are receiving denials left and right on these. I have made sure that the 25 and 59 mod is being used and that the correct dx code has been used. Main ins denials I have been receiving is medicaid and tricare. Not sure if I should be billing it differently then the other ins. Have u run across this?

  4. #4

    I looked up info on our Medi-Cal website and found out that the admin codes are on the following link and read the info at the top.

    Medi-cal also makes mention of using a special modifier for children in the VFC program.

    Also, read the info on the following section - it's got the exact way in which to bill vaccines to Medi-Cal and apparently, the claim form needs info in Box 19 of your claim form.

    I know I'm "Medi-Cal" and you're "Medicaid" but maybe this info would help you out. Good Luck!
    Sylvia Thompson, CPC
    Billing Supervisor
    San Diego, CA

Similar Threads

  1. administered fee for immun
    By ddebbied in forum Modifiers
    Replies: 2
    Last Post: 08-19-2011, 06:23 AM
  2. 90472
    By dballard2004 in forum Medical Coding General Discussion
    Replies: 3
    Last Post: 10-15-2010, 12:57 PM
  3. Flu Immun Codes for Fall 2010
    By sfinke in forum Billing/Reimbursement
    Replies: 1
    Last Post: 09-03-2010, 03:45 PM
  4. Cpx & Immun With Mod 25
    By MsMaddy in forum Family Practice
    Replies: 9
    Last Post: 07-21-2008, 03:00 PM

Posting Permissions

  • You may not post new threads
  • You may not post replies
  • You may not post attachments
  • You may not edit your posts
Enjoying Our Forums?

AAPC forums are a benefit of membership. Joining AAPC grants you unlimited access, allowing you to post questions and participate with our community of over 150,000 professionals.

Join Now Continue Reading Without Full Access

Already a Member?


Close Message

In addition to full participation on AAPC forums, as a member you will be able to:

  • Access to the largest healthcare job database in the world.
  • Join over 150,000 members of the healthcare network in the world.
  • Be a part of an industry leading organization that drives the business side of healthcare.
  • Save anywhere from 10%-50% with exclusive member discounts on courses, books, study materials, and conferences.
  • Access to discounts at hundreds of restaurants, travel destinations, retail stores, and service providers. AAPC members also have opportunities to save on heath, life, and liability insurance.
  • Become a member of a local chapter and attend regular meetings.