Tetanus and Diphtheria Vaccinations Billing GuidelinesCPT CodeICD-1090715S61011A90471S61011AAug 30, 2018
90472 – Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections); each additional vaccine (single or combination vaccine/toxoid). Example: RIV4 and Tdap are administered to an adult patient.
Z23 is the ICD-10 code that identifies an encounter for immunization(s).
IIS: NDC Lookup CrosswalkSale NDC11Sale Proprietary NameUse GTIN00006-4133-41Tetanus and Diphtheria Toxoids Adsorbed00006-4171-00ProQuad0030006417101300006-4329-02VAXNEUVANCE00006-4329-03VAXNEUVANCE33 more rows
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.
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.
According to ICD-10-CM guidelines, clinicians may assign code Z28. 310, “Unvaccinated for COVID-19,” when the patient has not received a dose of any COVID-19 vaccine. Clinicians may assign code Z28.
Providers may bill CPT 99401 with ICD-10 code Z71. 89 for no member cost-share. Providers are encouraged to counsel all members who have not yet received their COVID-19 vaccination. This service can be provided by MD/DO, NP, PA, and/or CNM.
Z00.00ICD-10 Code for Encounter for general adult medical examination without abnormal findings- Z00. 00- Codify by AAPC.
A35 - Other tetanus. ICD-10-CM.
DTaP vaccine can prevent diphtheria, tetanus, and pertussis. Diphtheria and pertussis spread from person to person. Tetanus enters the body through cuts or wounds.
90471: Immunization administration for percutaneous, intra-dermal, subcutaneous or intramuscular injections, initial.