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New Administration Codes 90460-90461

  1. Default New Administration Codes 90460-90461
    Medical Coding Books
    Do we know if the LPNs are "qualified" to counsel around this when there is only a nurse visit in NY State?
    Thank you,
    Caroline

  2. #2
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    Quote Originally Posted by caroline View Post
    Do we know if the LPNs are "qualified" to counsel around this when there is only a nurse visit in NY State?
    Thank you,
    Caroline
    It depends on your state scope of practice regs as to who is "qualified" to provide vaccine counseling.

  3. #3
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    Columbia, MO
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    Quote Originally Posted by caroline View Post
    Do we know if the LPNs are "qualified" to counsel around this when there is only a nurse visit in NY State?
    Thank you,
    Caroline
    What are you referring to as a nurse only? If the visit is a vaccine admin only? Or are you charging a 99211? or is there no physician on site?

    Debra A. Mitchell, MSPH, CPC-H

  4. #4
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    Madison Area Chapter in Madison WI
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    113
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    Quote Originally Posted by caroline View Post
    Do we know if the LPNs are "qualified" to counsel around this when there is only a nurse visit in NY State?
    Thank you,
    Caroline
    Caroline - This was a topic at the AMA conference this year. The presenters at the AMA's CPT Symposium went into a fair amount of detail on the correct usage of these codes. These new codes are only to be used when counseling is done with the vaccine. The provider must be a mid-level (NP, PA, etc.) or above. An RN etc are not considered "providers".

    The documentation needs to state the provider counseled on the specific vaccine and the risks/benefits of that vaccine. A statement like "Pt was counseled on risk and benefits" is not enough.

    The counseling codes would be billed for each vaccine in which counseling is performed and documented. For example, the patient receives one injection of the MMR vaccine. The provider counsels and documents the risk/benefits of the measles vaccine, the mumps vaccine, and the rubella vaccine. The counseling codes would be used three times.

    If the vaccines were given and no counseling was provided and documented, these codes woult not be used. I hope this is helpful
    Happy Coding, Claudia


    Claudia Yoakum-Watson, CPC
    Coding, Compliance, & Reimbursement Solutions
    [email]ccrsconsulting@tds.net
    ccrsconsulting.com - website

  5. Default
    Some ptaients are scheduled only for vaccine administration and the nurse administers vaccine.

  6. #6
    Location
    Madison Area Chapter in Madison WI
    Posts
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    In that case, the tried and true administration codes would be used. Not the counseling codes. Hope that is helpful.
    Happy Coding, Claudia


    Claudia Yoakum-Watson, CPC
    Coding, Compliance, & Reimbursement Solutions
    [email]ccrsconsulting@tds.net
    ccrsconsulting.com - website

  7. Default
    Claudia,
    What if my state scope of practice regs "qualifies" RN's?
    Is the AMA considering other qualified health care professional as only PA, NP and Midwives?
    Thank you,
    Caroline

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