| CPT Code | ICD-10 |
|---|---|
| 90715 | S61011A |
| 90471 | S61011A |
Article - Billing and Coding: Tetanus Immunization (A52438)
A35 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 A35 became effective on October 1, 2021. This is the American ICD-10-CM version of A35 - other international versions of ICD-10 A35 may differ.
ICD-10 requires only one code (Z23) per vaccination, regardless if single or combination. Report Z23 for all vaccination diagnoses.
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.
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.
Medicare prescription drug coverage (Part D) usually covers all commercially available vaccines needed to prevent illness, including the Tdap shot.
ICD-10-CM Description Clinicians may assign code Z28. 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.
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.
Code Z23 is used to indicate any encounter for a vaccination. The procedure codes are used to identify the type of the immunization given and how it was administered.
For individuals with MIS and COVID-19, assign code U07. 1, COVID-19, as the principal/first-listed diagnosis and assign code M35. 81 as an additional diagnosis.