Vaccination Codes – many 2011 changes….. (Change your superbill)

On November 5th, 2010, posted in: Industry News by

Earlier editions of CPT included vaccine administration codes 90465-90468 for children younger than 8 years of age when the physician counseled the patient/family. The 2011 version of CPT introduces two administration codes that expand the concept to include adolescent and teens and eliminates the distinction based on route of administration:

90460 immunization administration through 18 years of age via any route of administration, with counseling by physician or other qualified health care professional; first vaccine/toxoids component
90761 ……each additional vaccine/toxoids component – listed separately in addition to code for primary procedures.

Many of the new codes are based on the number of components in the vaccine.

Example, MMR:
In 2010 you are reporting: 90465 – administration – younger than 8……single or combination toxoids, per day. In 2011 you will report the same administration code, 90465 along with 90460- 1 unit and 90461 – 2 units because MMR has three components (measles, mumps, rubella).

Other examples of multiple vaccines include:
90696 – DTaP-IVP – ages 4 to 6 – IM
90698 – DTaP-Hib-IPV –
90710 – MMRV
90723 – DTaP-HepB-IPV
90748 – HepB-HIB

If you are treating infants and toddlers, there is a new vaccine product 90644 – meningococcal conjugate vaccine, serogroups C & Y and Hemophilus influenza B vaccine, tetanus toxoids conjugate (Hib-MenCY-TT), 4 dose schedule, when administered to children 2-15 months of age, IM use.

There are four (4) new influenza codes to add to your charge sheet:
90664 Influenza virus vaccine, pandemic formulation, live, for intranasal use
90666 Influenza virus vaccine, pandemic formulation, split virus, preservative free, IM use
90667 Influenza virus vaccine, pandemic formulation, split virus, adjuvanted, for IM use
90668 Influenza virus vaccine, pandemic formulation, split virus, for IM use

Also remember to add: (if you haven’t already)
90470 H1N1 immunization administration (IM, intranasal) including counseling when performed.