Results 1 to 7 of 7

Tetanus Toxid & E & M Coding

  1. #1
    Default Tetanus Toxid & E & M Coding
    Exam Training Packages
    If a patient comes into an urgent care for wound injury, how do you code the visit and the injection. We are coding E & M with 25 modifier, 90471 (administration) and 90718 and are getting denied from Medicare. Should I be using a different dx for the visit than I do for the other 2 codes?

  2. #2
    Columbia, MO
    what dx code(s) are you using and how are you linking them.

    Debra A. Mitchell, MSPH, CPC-H

  3. #3
    Default Tetanus Toxid & E & M Coding
    I am using 830.0, 959.5, and V03.7 on all 3 procedures.

  4. #4
    Columbia, MO
    you must unlink the 830.0 and the 959.5 from the tetanus injection and toxiod codes link only the V03.7. The tetanus injection is not given as therapeutic for the wound it is only for prophylactic measures.

    Debra A. Mitchell, MSPH, CPC-H

  5. #5
    North Carolina
    My carrier has a policy for this:

    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 - Immunizations)

  6. #6
    Daytona Beach, FL
    Who is your Medicare carrier? I code for an Urgent Care, our Medicare carrier is Highmark and we would get denied for the tetnus also. I spoke with Medicare about this and was told we needed to add modifier AT to the tetnus and the injection. Since we added this modifier we always get paid by Medicare.

    I would check with you carrier to see if they require this modifier and also bill the charge with the tetnus toxoid V code as the PDX.

    Hope this helps.
    Jodi Dibble, CPC

  7. #7
    Grand island Nebraska
    Default What is modifier AT?
    I am not familiar with modifier AT?

Similar Threads

  1. Medicare & tetanus
    By cmercado0526 in forum Medicare Regulations
    Replies: 0
    Last Post: 10-12-2015, 08:42 AM
  2. ICD9 allowable coding for 93880 & 83882 & 93875
    By twinger in forum Medical Coding General Discussion
    Replies: 0
    Last Post: 01-14-2014, 01:09 PM
  3. 90718 Tetanus Toxid
    By martyzal in forum Medical Coding General Discussion
    Replies: 4
    Last Post: 05-03-2010, 08:02 AM
  4. Please help coding EGD,BX & Cold Bx & Polyp
    By Hopp in forum Gastroenterology
    Replies: 1
    Last Post: 04-14-2010, 03:39 PM
  5. E&M coding technical & professional component
    By Karin Brown in forum E/M
    Replies: 2
    Last Post: 04-13-2010, 12:14 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.