# Tetanus j code?



## Pillow1 (Dec 16, 2010)

For a medicare patient i billed 90718 and 90471 /  vo6.5
but it was denied as a co 96 non covered item...
Is this a benefit that only covered once?
Any feedback is appreciated. 
Thanks


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## RebeccaWoodward* (Dec 16, 2010)

Tetanus is only covered when related to an injury

Tetanus and Tetanus/Diphtheria Toxoids (90702, 90703, 90714, and 90718)
When filing claims for 90702, 90703, 90714, or 90718, the primary diagnosis should be one of the ICD-9 "V" codes indicating the need for prophylactic vaccination against bacterial diseases or combinations of diseases (V03.7 Tetanus toxoid alone or V06.5 tetanus-diphtheria) plus an injury related ICD-9 code as the secondary diagnosis. Tetanus or tetanus-diphtheria (Td) toxoids adsorbed are only covered when directly related to the treatment of an injury/wound. For further instructions, please visit the Centers for Medicare Medicaid Services website to view the Internet Only Manuals (IOM) – *Medicare Benefit Policy Manual (Pub 100-2, Chapter 15, Section 50.4.4.2* - Immunizations

http://www.cms.gov/manuals/Downloads/bp102c15.pdf


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## dballard2004 (Dec 17, 2010)

RebeccaWoodward* said:


> Tetanus is only covered when related to an injury
> 
> Tetanus and Tetanus/Diphtheria Toxoids (90702, 90703, 90714, and 90718)
> When filing claims for 90702, 90703, 90714, or 90718, the primary diagnosis should be one of the ICD-9 "V" codes indicating the need for prophylactic vaccination against bacterial diseases or combinations of diseases (V03.7 Tetanus toxoid alone or V06.5 tetanus-diphtheria) plus an injury related ICD-9 code as the secondary diagnosis. Tetanus or tetanus-diphtheria (Td) toxoids adsorbed are only covered when directly related to the treatment of an injury/wound. For further instructions, please visit the Centers for Medicare Medicaid Services website to view the Internet Only Manuals (IOM) – *Medicare Benefit Policy Manual (Pub 100-2, Chapter 15, Section 50.4.4.2* - Immunizations
> ...



Rebecca,

When I reference the Medicare Manual, all it says is that vaccines (except for the flu, pneumonia, and Hep B vaccines) are only covered if administered for treatment of an injury or exposure to disease.  Where does it say that the V code has to be first and an open wound code as secondary.  Can you point me to your source for this info or is this a local carrier guidance?


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## RebeccaWoodward* (Dec 17, 2010)

Hi Dawson,

Below is my carriers reference to the "V" code.

http://www.cignagovernmentservices.com/partb/pubs/news/2006/1006/cope4903.html


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## dballard2004 (Dec 17, 2010)

Thanks!


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