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.
ICD-10 code Z23 for Encounter for immunization is a medical classification as listed by WHO under the range - Factors influencing health status and contact with health services .
Code 90460 is reported once for the first component of each vaccine or toxoid administered by any route. The reporting of code 90460 includes counseling for the first vaccine component. Code 90461 is additionally reported for the counseling associated with each additional component of any combination vaccine or toxoid.
To report a single intramuscular vaccination, report 90471. To report three intramuscular injections, report 90471 for the initial intramuscular vaccination administration and 90472 x 2 for the additional intramuscular administrations.
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.
ICD-10 code Z71. 85 for Encounter for immunization safety counseling is a medical classification as listed by WHO under the range - Factors influencing health status and contact with health services .
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.
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.
Z23 may be used as a primary diagnosis for immunizations in the OP and physician setting.
CPT Assistant, November 2000 states that code 90472 is to be reported one time for each addtional vaccine administered. I agree that modifier 59 should also be used on each addtional 90472 code.
Subsequent vaccines All subsequent vaccine codes (90472 and 90474) are classified as add-on codes and must be reported with an initial administration 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.