# Tetnus injection due to injury



## aboyd83 (Jul 1, 2014)

For a tetnus injection due to injury, would this be billed as 90703 and also the j1670? This was done on the same day as an e&m. Would that then make it to where we would need to bill the ov and the j code with the 90703 being included in the e&m? I am having a hard time finding any info on this.


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## MarcusM (Jul 1, 2014)

Codes 90476-90748 identify the vaccine product only. To report the administration of a vaccine/toxoid, the vaccine/toxoid product codes 90476-90749 must be used in addition to an immunization administration code(s) 90460-90474
J1670 is injection of tetanus immune globulin (TIG), human, up to 250 units but this may not be needed if wound <24 hours old. Tetanus immune globulin provides a passive immunity for injuries that are over 24 hours old, for injuries that are extensively contaminated, and for clients who have had fewer than 2 tetanus toxoid injections in a lifetime. Therefore, both procedure codes 90703 and J1670 can be given on the same day, for the same injury event.
After an acute penetrating or invasive injury, prevention of tetanus is accomplished through appropriate wound cleansing and debridement and the administration of human TIG, when indicated. TIG is indicated for prophylaxis against tetanus following an acute penetrating or invasive injury in a client whose immunization is incomplete or uncertain.

So you should bill for the E&M with the shot(s) and administration of the shot(s).


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## aboyd83 (Jul 2, 2014)

I just want to clarify since the wording on the LCD is a little tricky. We would bill the e&m, modifier 25 and then both the 90703 and the j1670 since his wound was less than 24 old correct? Or is the j1670 not needed since it is less than 24hrs old?


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## MarcusM (Jul 2, 2014)

If the wound is less than 24 hours old and is not a "extensively contaminated" wound and your provider did not inject the J1670, then you would bill the E&M with modifier 25, CPT 90703 for Tetanus toxoid adsorbed, for intramuscular use, and the administration CPT 90471.


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## aboyd83 (Jul 2, 2014)

Awesome! Thank you, with us being ortho, we dont usually run into this, it is usually handled at the hospital before it comes to us!


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