ICD-10 Code: Z23 Get payment allowances & effective dates for the 2021-2022 season. Learn about claims & roster billing.
ICD-10 requires only one code (Z23) per vaccination, regardless if single or combination. Report Z23 for all vaccination diagnoses.
If you administer an injection of the influenza vaccine only, report 90471. If you administer an influenza vaccine in addition to other vaccines, report the influenza injection with 90472. Note that code 90471 or 90473 cannot be reported in conjunction with 90460.
According to ICD-10-CM guidelines, clinicians may assign code Z28. 310, “Unvaccinated for COVID-19,” when the patient has not received a dose of any COVID-19 vaccine. Clinicians may assign code Z28.
Use the CPT code for the vaccine administered (90685) and link to the diagnosis code for the immunization. Because qualified counseling occurred for a patient younger than 18 years of age, bill 1 unit of 90460 for administering influenza vaccine. Link to the immunization diagnosis code.
Code Z23, which is used to identify encounters for inoculations and vaccinations, indicates that a patient is being seen to receive a prophylactic inoculation against a disease. If the immunization is given during a routine preventive health care examination, Code Z23 would be a secondary code.
Z23 may be used as a primary diagnosis for immunizations in the OP and physician setting.
Payment Allowances and Effective Dates for the 2021-2022 Flu Season:CodeLabeler NameVaccine Name90662Sanofi PasteurFluzone High-Dose Quadrivalent (2021/2022)90672MedImmuneFluMist Quadrivalent (2021/2022)90674SeqirusFlucelvax Quadrivalent (2021/2022) (Pres Free)90682Sanofi PasteurFlublok Quadrivalent (2021/2022)6 more rows•Dec 22, 2021
Use CPT code 90682 for RIV4 vaccine and link to the ICD-10 code for routine immunization (Z23). Use CPT code 90471 to code for administration because the patient is an adult and this is the first vaccine administered at the visit. Link to ICD-10 Z23.
The Z23 code includes the following note: “Code first any routine childhood examination.” Therefore, when you provide immunizations in conjunction with a well-child visit, a code for routine child health examination should be reported first, followed by Z23 for any immunizations. This is similar to ICD-9 rules.
X2 – Influenza Due to Identified Novel Influenza A Virus with Other Respiratory Manifestations.
encounter for a vaccinationCode Z23 is used to indicate any encounter for a vaccination. The procedure codes are used to identify the type of the immunization given and how it was administered. All Z codes must be accompanied by a corresponding procedure code.
The 90460 code is used when a physician is present and performs face-to-face counseling to the caregiver or parent. This code can only be used for patients through age 18. Code 90471 is used when the drug is administrated by a medical assistant or nurse and the patient does not see the physician at all.
90471: Immunization administration for percutaneous, intra-dermal, subcutaneous or intramuscular injections, initial.
For vaccines given the same day as a G-Code vaccine, use 90471. For example, if a patient receives a flu shot and tetanus shot, you would bill G0008 for the flu vaccine and 90471 for the tetanus vaccine; also add modifier 59 (distinct procedural service) to the G code.