They are incorrect in stating that 90460-90461 are the only codes for 18 and under. 90471 and other non-counseling codes are for EITHER, individuals over 18 or for individuals not receiving counseling. Keep fighting them on it.
We had to fight our local Medicaid to start paying for the new codes..they weren't aware of them!
Now that being said, are your doctors telling you they are not counseling the patients/parents about the vaccines? I would find it hard to believe they aren't educating them on the risks, etc. All we did was add a line to the vaccine record where the doctor can initial each vaccine component and we now bill the 90460-61 codes.
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