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Vaccine Admin. Codes

  1. #1
    Question Vaccine Admin. Codes
    Medical Coding Books
    I have a question regarding the vaccine administration codes, we currently use 90471,90472, 90473 and 90474 as needed and required. However our billing office is questioning why we are not billing the 90465-90468. I explained our nursing staff provided hand outs on the vaccines and the physicians do not counsel on them.
    I did some research and found the doctor sould be counseling on signs ,symptoms of adverse effects and when to seek medical care for any adverse effects. Can anyone tell me what the doctor documents in the chart?and how long it takes for the doctor to review each vaccine with patient/parents?
    Thank you,
    Erlinda Arreygue C.P.C.

  2. #2

    I found the following info on aapc website:

    Vaccines and their administration

    CPT 2005 includes new codes (90465-90468) for immunization administration for patients under 8 years of age when the physician counsels the patient or the patient's family. You should report these codes only when the patient is under 8 years of age and the physician provides face-to-face counseling during the administration of a vaccine. Otherwise, you should report vaccine administration using the current administration codes, 90471-90474.

    Further, I found a very interesting article put out by "American Academy of Pediatrics" that speaks about imm admin codes, including those you reference in your post. Below is the link:

    Hope this helps you & Good Luck!
    Sylvia Thompson, CPC
    Billing Supervisor
    San Diego, CA

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