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.
You can mix and match 90460-90461 and 90471-90474 if the provider counsels the patient on some, but not all, of the vaccines or vaccine/toxoid components administered.
90471: Immunization administration for percutaneous, intra-dermal, subcutaneous or intramuscular injections, initial.
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.
Z23 is the ICD-10-CM code used when reporting an encounter for immunization for all vaccines given within the encounter.
90471 One vaccine, single or combination vaccine/toxoid. Immunization administration (includes percutaneous, intradermal, subcutaneous or intramuscular injections). 90472 Each additional 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.
CPT® code 96372: Injection of drug/substance under skin or into muscle | American Medical Association. Overdose Epidemic.
96372 CPT code is used for the administration of any diagnostic, therapeutic, or prophylactic substance (a drug, a fluid, etc.) by a physician or assistant.
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.
If 90471 does not represent a duplicate of the service described by HCPCS code, modifier 59 may be to the 90471 code. In addition a diagnosis code specific to the disease for which the prophylactic vaccine is being administered, it should be linked to 90471.
Medicaid Billing Providers must bill with CPT code: 90750 - Zoster (shingles) vaccine, (HZV), recombinant, sub-unit, adjuvanted, for intramuscular injection.
o For administration and physician counseling (CPT 90460-90461) of multiple component vaccines, provided to children 18 years of age or younger, submit 90460 for the first component administered, and 90461 for each additional component included in the vaccine. o Report one initial administration code per day, ...
Note that code 90471 or 90473 cannot be reported in conjunction with 90460. Therefore, if during a single encounter, a patient receives multiple vaccines and there is counseling on all but the influenza vaccine, report 90472 or 90474 in addition to 90460 and 90461 as appropriate.
Tetanus and Diphtheria Vaccinations Billing GuidelinesCPT CodeDescription90714Tetanus and diphtheria toxoids (Td) older than age 790715Tetanus, diphtheria toxoids and acellular pertussis vaccine (Tdap)90471Immunization administration90472Immunization administrationAug 30, 2018
Claims for CPT codes 90702, 90714, J1670 are payable under Medicare Part B in the following places of service: office (11), urgent care facility (20) , nursing facility (32), and independent clinic (49).