Otolaryngology Coding Alert

Question: A 24-year-old patient receives a .1 ml microinjection of Fluzone Intradermal Quadrivalent Vaccine. I don't have much experience coding for influenza vaccination administrations. What codes should I use?

Montana Subscriber

Answer: You will need additional information in order to determine the correct set of codes for this patient. Since the patient is within the age range of 18-64, the vaccination code will be 90630 (Influenza virus vaccine, quadrivalent (IIV4), split virus, preservative free, for intradermal use). As for the administration code, you have a few varying options depending on the patient's insurance and the circumstances surrounding the visit. For Medicare beneficiaries, you will always apply code G0008 (Administration of influenza virus vaccine) for vaccination administration. This is true for all types of influenza vaccinations.

On the other hand, for commercial payers, you have a few different codes to decide from. Since this patient is presumably using a commercial payer, you will be deciding between code 90471 (Immunization administration [includes percutaneous, intradermal, subcutaneous, or intramuscular injections]; 1 vaccine [single or combination vaccine/toxoid]) and 90460 (Immunization administration through 18 years of age via any route of administration, with counseling by physician or other qualified health care professional; first or only component of each vaccine or toxoid administered).

If the patient receives the immunization without any counseling before or after, then you will use 90471. If the patient requests counseling on the various safety concerns surrounding vaccinations, for instance, then the provider may feel enough counseling is warranted for code 90460.