ICD-10 requires only one code (Z23) per vaccination, regardless if single or combination. Report Z23 for all vaccination diagnoses.
Coding & Reimbursement 90662=Inactivated Influenza Vaccine, quadrivalent (IIV4), split virus, preservative free, enhanced immunogenicity via increased antigen content, for intramuscular use.
Inoculations and Vaccinations ICD-10-CM Coding 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.
ICD-10-CM Code for Influenza due to other identified influenza virus with other respiratory manifestations J10. 1.
Payment Allowances and Effective Dates for the 2021-2022 Flu Season:CodeLabeler NameEffective Dates90672MedImmune08/26/2021 – 07/31/202290674Seqirus08/11/2021 – 07/31/202290682Sanofi Pasteur08/01/2021 – 07/31/202290685Sanofi Pasteur Seqirus08/01/2021 – 07/31/20226 more rows•Dec 22, 2021
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.
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 .
ICD-10-CM Codes that Support Medical Necessity Tetanus, Diphtheria and Pertussis vaccines (CPT codes 90702, 90714, and 90715) Diagnosis codes must be coded to the highest level of specificity.
(a) When a person who may or may not be sick encounters the health services for some specific purpose, such as to receive limited care or service for a current condition, to donate an organ or tissue, to receive prophylactic vaccination (immunization), or to discuss a problem which is in itself not a disease or injury.
9: Fever, unspecified.
Influenza due to other identified influenza virusInfluenza due to other identified influenza virus with the same other identified influenza virus pneumonia. J10. 01 is a billable/specific ICD-10-CM code that can be used to indicate a diagnosis for reimbursement purposes. The 2022 edition of ICD-10-CM J10.
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.
Use the CPT code for the vaccine administered (90686) 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.
OFFICE VISITS FOR IMMUNIZATION Can code 99211, “Office or other outpatient visit for the evaluation and management (E/M) of an established patient that may not require the presence of a physician,” be reported when a patient presents for a flu shot? Code 99211 is not typically paid in the situation you describe.
A modifier -25 may be required for the office visit when a vaccine is administered. Modifier -25 indicates that the E/M code for the office visit represents a distinct and significant service that is separate from the vaccine administration.