90471

Vignina Medicaid is constantly refusing our 90471 vaccine admin code, we are using appropiate ICD9 code with all the vaccination. They told us that it is not billable and we can not bill our patient either. Any suggestions?

re: 90471

There are a new set of administration vaccine codes came into effective for medicaid
In our office we use 90460 and 90461.These codes should be used for patients younger than 18 years of age. Billing of these codes depends on the components of the vaccine codes. If for example a pt was given DTap under 7 yrs of age then CPT® code is 90700. CPT® code 90700 has 3 components, Billing would be as follows
90700
90460
90461X2

If (pediarix) is given it has a total of 5 components
first vaccine code
90460
90461X4

Code 90460 is reported once for the first component of each vaccine or toxoid administered by any route. 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.

Hope its clear
On using the codes 90460 and 90461 instead of 90471,90472 we also get highet reimburement