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Thread: Need help on CPT 90461 !!

  1. #1

    Default Need help on CPT 90461 !!

    AAPC: Back to School
    Hi all,

    we have been billing DTaP vaccine as

    Can we get the payement for additional components CPT 90461 x 2 now?

    Please help me how to bill these two additional components of the vaccine DTaP.

    Thanks a lot in advance !!!

    Prem kumar B.Pharm;CPC,CCS

  2. #2
    Join Date
    Apr 2007


    Dtap we bill as 90700 90460 90461x2. We are getting paid for all components.

  3. #3

    Default need to resubmit the claim 90461

    Hi Thx for your reply.

    Please tellme how to rebill them this vaccine was already billed and got the payment also,but here problem is we had billed as 90700 and 90460. We did not bill as 90700,90460 and 90461x2

    Now we want to bill those previous claims for these 90461x2 CPTs.

    Please guide me....


  4. #4
    Join Date
    Apr 2007


    I would send a corrected claim to the Insurance company with a copy of the EOB and they should make an adjusted payment to you.

  5. #5
    Join Date
    Apr 2007
    Ft. Worth, Texas


    You would send a corrected claim to the insurance company. Attach a letter/form stating the correction along with the claim number, patient name, DOB subscribers name and Insurance ID and group number. On the corrected HCFA 1500 mark it corrected claim and put the claim number on it. You have to watch these claims because the insurance company may state it is a duplicate. If so call them and explain.


  6. #6
    Join Date
    Apr 2007
    Raliegh North Carolina


    I found out our pediatricians have not been billing the 90460 or 90461 when the child has been given immunizations. This is the documentation I have located in the patients' charts and I believe it is adequated to meet the counseling requirement:
    "Procedure risk and benefits, indications, purpose, complications, alternative options, we discused with the patient;parent signed consent form.
    If anyone has better documentation suggestions, I would love to hear them. I just want to have a second opinion before I tell the docs they are missing revenue.
    Cheryl Alexander, CPC

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