Tetanus and Diphtheria Vaccinations Billing GuidelinesCPT CodeICD-1090715S61011A90471S61011AAug 30, 2018
A33 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 A33 became effective on October 1, 2021.
Z23 is the ICD-10 code that identifies an encounter for immunization(s).
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.
Article - Billing and Coding: Tetanus Immunization (A52438)
Tetanus Toxoid (CPT 90703) Immunizations, vaccinations, or inoculations are covered by Medicare only when there has been direct exposure of the associated disease to the patient and there is significant risk that the patient could contract the disease as a result of the exposure.
ICD-10-CM Description 311, “Partially vaccinated for COVID-19,” when the patient has received at least one dose of a multi-dose COVID-19 vaccine regimen, but has not received the doses necessary to meet the CDC definition of “fully vaccinated” at the time of the encounter.
Report codes 90471-90474 for immunization administration of any vaccine that is not accompanied by face-to-face physician or other qualified health care professional counseling the patient and/or family, or for patients over 18 years of age.
The Z23 code includes the following note: “Code first any routine childhood examination.” Therefore, when you provide immunizations in conjunction with a well-child visit, a code for routine child health examination should be reported first, followed by Z23 for any immunizations. This is similar to ICD-9 rules.
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. This code would also be used for any patient 19 years of age or older regardless if physician is present and does face-to-face counseling.
• Code Z23 is for encounters for inoculations and vaccinations. • It means patient is being seen to receive a prophylactic inoculation against a disease. • Code Z23 may be used as a secondary code if the inoculation is given as a routine part of preventive health care, such as a well-baby visit.