| CPT Code | ICD-10 |
|---|---|
| 90715 | S61011A |
| 90471 | S61011A |
Medical providers who “buy and bill” for the Tdap vaccine should use the Current Procedural Terminology (CPT) code 90715. For administration of the vaccine, providers should bill CPT code 90471 or 90472, as appropriate.
ICD-10 requires only one code (Z23) per vaccination, regardless if single or combination. Report Z23 for all vaccination diagnoses.
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.
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.
For immunization administration other than COVID-19, codes 90460–90474 are reported for the administration of the vaccine, along with the appropriate vaccine/toxoid code (90476–90756) targeting the organism.
If the immunization is related to exposure (eg, the administration of a Tdap vaccine as a part of wound care), the ICD-10 code describing the exposure should be used as the primary diagnosis code for the vaccine, and Z23 should be used as the secondary 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.
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.
90471 is an Immunization administration code. TB TEST IS NOT AN IMMUNIZATION. Furthermore 96372 is for Therapeutic/Diagnostic injection, Subcutaneous or Intramuscular.
90460 – Immunization administration through 18 years of age via any route of administration, with counseling by physician or other qualified health care professional; first or only component of each vaccine or toxoid administered.
Immunization administration for90471: Immunization administration for percutaneous, intra-dermal, subcutaneous or intramuscular injections, initial.
These codes report immunization administration to patients 18 years of age or younger. Use 90460 for each vaccine administered. For vaccines with multiple components [combination vaccines], report CPT code 90460 in conjunction with 90461 for each additional component in a given vaccine.
Immunization Administration Add-ons The immunization administration codes 90460-90461, 90471-90474 or G0008-G0010 are reported in addition to the vaccine or toxoid code(s) 90476-90756, Q2034-Q2039. When giving more than one vaccine/toxoid, multiple administration codes are reported.
The Vaccine 90746 is the actual serum that you are using and the administration 90471 is the act of giving the injection so they are both primary with no bundleing, it is the same as a 96372 with a J code for the drug.