| ICD Code | ICD Description | Avg. LOS |
|---|---|---|
| V066 | Need for prophylactic vaccination and inoculation against streptococcus pneumoniae [pneumococcus] and influenza | 5.54 |
| V061 | Need for prophylactic vaccination and inoculation against diphtheria-tetanus-pertussis, combined [DTP] [DTaP] | 4.63 |
Tetanus and Diphtheria Vaccinations Billing GuidelinesCPT CodeICD-1090715S61011A90471S61011AAug 30, 2018
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.
Tetanus vaccinations are eligible for Medicare Part B coverage when they are directly related to the treatment of an injury or direct exposure to a disease or condition....Avoid claim processing delays when billing tetanus vaccinations.CPT® CodeDescriptor90715Tetanus, diphtheria toxoids and acellular pertussis vaccine, older than 790471Immunization administration2 more rows•Jul 17, 2022
ICD-10 requires only one code (Z23) per vaccination, regardless if single or combination. Report Z23 for all vaccination diagnoses.
Counseling is provided by the physician. Bill administration using 1 unit of 90460. Example: DTaP-IPV/Hib, a 5-component vaccine, is administered to a pediatric patient, and counseling is provided by the nurse practitioner. Bill for administration using 1 unit of 90460 and 4 units of 90461.
ICD-10 code A33 for Tetanus neonatorum is a medical classification as listed by WHO under the range - Certain infectious and parasitic diseases .
Tdap (Tetanus, Diphtheria, and Pertussis) and Td (Tetanus and Diphtheria) Vaccine. Tdap vaccine protects against tetanus, diphtheria, and whooping cough (pertussis). Td vaccine protects against tetanus and diphtheria.
Tdap shots don't cover the Tdap shot. Medicare prescription drug coverage (Part D) usually covers all commercially available vaccines needed to prevent illness, including the Tdap shot.
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 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.
Immunization administration for90471: Immunization administration for percutaneous, intra-dermal, subcutaneous or intramuscular injections, initial.
90472 Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections); each additional vaccine (single or combination vaccine/toxoid) (list separately in addition to code for primary procedure)
90471 – Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections); 1 vaccine (single or combination vaccine/toxoid).
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.