Internal Medicine Coding Alert
Fight for FluMist Pay With This Rule
Question: We have begun administering FluMist along with well checks and other immunizations. For the administration code of FluMist, denials are coming in that state "90473 cannot be billed with 90471 or +90472." Has anyone else had this issue yet? Missouri Subscriber Answer: Codes 90471 (Immunization administration [includes percutaneous, intradermal, subcutaneous, or intramuscular injections]; one vaccine [single or combin-ation vaccine/toxoid]) and 90473 (Immunization administration by intranasal or oral route; one vaccine [single or combination vaccine/toxoid]) are for initial immunization administration. You cannot report both together. "Do not report 90473 in conjunction with 90471," according to CPT's parenthetical instruction after 90473. You indicate that you are administering FluMist in addition to other immunizations. When giving intranasal and injectable vaccines, you should report the injectable vaccine shots before the inhaled administration. For instance, you would code the administration of two injectable vaccines plus FluMist with codes 90471, +90472 (... each additional vaccine [single or combination vaccine/toxoid] [List separately in addition to code for primary procedure]), and +90474 (... each additional vaccine [single or combination vaccine/toxoid] [List separately in addition to code for primary procedure]).
Internal Medicine Coding Alert
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