Results 1 to 7 of 7

New 2011 admin codes 90460 and 90461

  1. #1
    Location
    Greeley, Colorado
    Posts
    2,045
    Question New 2011 admin codes 90460 and 90461
    Medical Coding Books
    I am trying to understand the correct use of these codes. Specifically, the descriptions state vaccine component and each additional vaccine component. The 2011 CPT Insiders View states that a "component refers for each antigen in a vaccine that prevents disease(s) caused by one organism".
    What exactly does that mean?
    Does it mean that if 90698 (Petnatcel DTap-Hib-IPV) we would report 90460 x1 and 90461 x2?
    Lisa Bledsoe, CPC, CPMA

  2. #2
    Location
    Evansville Indiana
    Posts
    451
    Default vaccines
    That is the way that I understand it.
    LeeAnn

  3. Default 2011 new vaccine admin codes
    That is how I understand it as well. It depends on the # of components in the vaccine and 90460 is first with 90461 used times the number of other components. But also, the patient has to be counseled also either by a physician or a qualified healthcare professional per the CPT book description. So if a patient comes in for shots only and sees the nurse only, I am thinking the nurse is considered a qualifed healthcare professional. If not, we have to use 90471 which is no longer age specific.

    Can anyone clarify that for me please? We have a debate going as to whether or not a nurse shot-only visit is considered as counseling. I think it is. Thank you!

  4. #4
    Location
    Kansas City, MO
    Posts
    431
    Default
    Quote Originally Posted by Lisa Curtis View Post
    I am trying to understand the correct use of these codes. Specifically, the descriptions state vaccine component and each additional vaccine component. The 2011 CPT Insiders View states that a "component refers for each antigen in a vaccine that prevents disease(s) caused by one organism".
    What exactly does that mean?
    Does it mean that if 90698 (Petnatcel DTap-Hib-IPV) we would report 90460 x1 and 90461 x2?
    According to the American Academy of Pediatrics, for 90698, you would have 90460x1, and 90461x4 (diptheria, tetanus, pertusis, polio, hib=5 components total)

  5. #5
    Location
    Kansas City, MO
    Posts
    431
    Default
    As far as who qualifies as a "qualified healthcare professional"...thats still not clear to me. From everything I read, I'm leaning toward thinking this means a physician or NP...the actual billing provider.
    AAP says to refer to your states scope practice laws to see who this is....still trying to figure that out!

  6. #6
    Location
    Greeley, Colorado
    Posts
    2,045
    Question
    Quote Originally Posted by LindaEV View Post
    According to the American Academy of Pediatrics, for 90698, you would have 90460x1, and 90461x4 (diptheria, tetanus, pertusis, polio, hib=5 components total)
    This is going to completely confuse the nurses and providers. Unfortunately, they do the coding (I educate and do the clean-up). I believe the counseling must be done by the physician or NPP, not the office nurse. Then the question arises, can 90460 and 90461 be reported with the preventive visits when counseling is already considered a factor?
    Lisa Bledsoe, CPC, CPMA

  7. Default 90460 and 90461
    The way I understand it you have to code each component antigent example in the cpt book it seems like you will count the Dtap-IPV 2 meaning you will put the 90460x2 and for the the MMR/Varicella combined with Dtap-IPV 90461x6. At work a discussion was brought up on how it should be coded and that was to count every antigen that was given. For example you have the 90696 Dtap-Polio you have the diptheria that is 1st antigen,tetanus toxoids 2nd antigen, acellular pertussin 3rd antigen, and poliovirus 4th antigen.

    Now you have Measles that is 1st antigen, mumps 2nd antigen, rubella 3rd antigen, and the varicella 4th antigen.

    you would code the first two components the diptheria and the mumps bill the 90460x2 and for the tetanus toxoids,acellular pertussin, poliovirus ,measles, rubella and the varicella these are the other antigens that we will use the 90461x6.

Similar Threads

  1. 90460 and 90461
    By ALLIE1 in forum Medical Coding General Discussion
    Replies: 1
    Last Post: 06-27-2011, 10:13 AM
  2. New CPT codes 90460 and 90461
    By DebbiePottsEngland in forum Pediatrics
    Replies: 50
    Last Post: 05-19-2011, 10:50 AM
  3. New Administration Codes 90460-90461
    By caroline in forum Pediatrics
    Replies: 6
    Last Post: 01-18-2011, 09:36 AM

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?

Login

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.