icd 10 cm code for gaurdisil shots

by Mr. Tracey Reinger 3 min read

The following uses and restrictions for Human Papilloma Virus (HPV) vaccines CPT code 90649 (Gardasil®) and CPT code 90650 (Cervarix®) are effective for claims dates of service on/after Oct.Jun 28, 2011

What is the ICD-10 code for screening for HPV?

ICD-10 code Z11. 51 for Encounter for screening for human papillomavirus (HPV) is a medical classification as listed by WHO under the range - Factors influencing health status and contact with health services .

How do I bill for Gardasil?

Use 90472 in conjunction with 90460, 90471, or 90473. There can be only 1 first administration during a given visit. Effective for dates of service on or after October 1, 2020, encounter for immunization. Report 90461 in conjunction with 90460.

Is Z23 a preventive code?

Vaccines Administered at Well-child Visits ICD-10 requires only one code (Z23) per vaccination, regardless if single or combination.

What is the age limit for CPT 90651?

​CPT code 90651 (HPV Vaccine) has a new upper limit age restriction for adult usage of 45 years of age effective 08/16/2019. For adults age 27-45, providers can consider discussing HPV vaccination with members who are most likely to benefit.

How do I code 90651?

CPT® Code 90651 in section: Human Papilloma virus (HPV) vaccine.

What is the administration code for 90732?

--In order to prevent duplicate payment by the same carrier, CWF will edit by line item on the carrier number, the HIC number, the date of service, the flu procedure codes 90657, 90658, or 90659, the pneumonia procedure code 90732, and the administration code G0008 or G0009.

What is the CPT code for HPV vaccine?

CPT code 90650 is an FDA-approved HPV vaccine for females only age 9-26. For recipients age 9-18, code 90650 is reimbursed through the VFC program. The three-dose schedule for either code for recipients over age 18 must begin and end before the recipient turns 27.

When do you use ICD-10 code Z23?

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.

What is diagnosis code Z71 89?

Other specified counselingICD-10 code Z71. 89 for Other specified counseling is a medical classification as listed by WHO under the range - Factors influencing health status and contact with health services .

Does insurance cover GARDASIL vaccine?

Although Gardasil 9 has a price tag of between $400 and $500 for a three-dose schedule, the good news is that the vaccine should be covered at no cost by most insurance plans and the Vaccines for Children (VFC) program for those who are eligible.

Is GARDASIL covered?

Many private insurance plans reimburse some or all of the cost of GARDASIL®9. Find out if your plan does. If you have a drug benefit wallet card, simply present your card to a pharmacist along with the Drug Identification Number (DIN) for GARDASIL®9 (02437058) and ask if you are covered.

What is difference between GARDASIL and GARDASIL 9?

What is the difference between GARDASIL®* and GARDASIL®9? GARDASIL®9 is a vaccine (injection/shot) that helps protect against some diseases caused by 9 types of Human Papillomavirus (HPV). GARDASIL®9 contains the same 4 HPV types (6, 11, 16, 18) as in GARDASIL®* with 5 additional HPV types (31, 33, 45, 52, 58).

Does insurance pay for Gardasil?

Gardasil 9 is covered by most insurance plans for those in the approved age range—9 to 26—because it counts as preventive care, which is supposed to involve no charge or copay.

Does CPT 90651 need a modifier?

(Gardasil®9) The administration fee for CPT code 90651(Human Papillomavirus vaccine types 6, 11, 16, 18, 31, 33, 45, 52, 58, nonavalent [9vHPV], 2 or 3 dose schedule, for intramuscular use) is reimbursable when billed with modifier SL for males and non-pregnant females 9 through 18 years of age.

Is Gardasil covered by Medicare?

Do Medicare prescription drug plans cover Gardasil 9? Yes. 100% of Medicare prescription drug plans cover this drug.

Does insurance cover HPV vaccine?

Luckily, many health insurance companies cover the HPV vaccine. There are also programs that help some people without insurance get the vaccine for low or no cost.