New 1999 Immunization and Neonatal Intensive Care Codes Most Valuable to Pediatrics
Published on Sun Nov 01, 1998
The 1999 CPT codes, which will become effective in January, include new codes in two important areas for pediatricians: immunizations and neonatal intensive care. As we noted in the September issue, these new codes are expected to help pediatric practices get better reimbursement, although the sheer mass of new, highly specific vaccine codes may be overwhelming at first.
New Vaccine Codes Cover Administration, Different Dosages
First of all, pediatricians now have the long-awaited codes for administration of vaccines: CPT 90471 for administration of a single or combination vaccine; 90472 for administration of two single or combination vaccines. These include percutaneous, intradermal, subcutaneous, intramuscular and jet injections and/or intranasal or oral administration. If immunizations are given as part of preventive care services (99381-99385, 99391-99395), you should use those codes as well. You must also report the vaccine code.
Note: The question remains: Will insurance companies pay for these new codes? Look for the results of a reader survey on this topic early next year in PCA.
The vaccine codes have now been divided into different dosage schedules. The reason for this is that the exact product needs to be reported in order to track vaccine distribution and the occurrence of adverse events. CPT makes it clear that you must use a combination codeand not individual componentsif you are using a combination vaccine. If a specific code is not available, you should use the unlisted procedure code (90749). Here are the new codes.
90633Hepatitis A vaccine, pediatric/adolescent dosage - 2 dose schedule, for intramuscular use
90634Hepatitis A vaccine, pediatric/adolescent dosage - 3 dose schedule, for intramuscular use
90645Hemophilus influenza b vaccine (Hib), HbOC conjugate (4 dose schedule), for intramuscular use
90646Hemophilus influenza b vaccine (Hib), PRP-D conjugate, for booster use only, intramuscular use
90647Hemophilus influenza b vaccine (Hib), PRP-OMP conjugate (3 dose schedule), for intramuscular use
90648Hemophilus influenza b vaccine (Hib), PRP-T conjugate (4 dose schedule), for intramuscular use
90657Influenza virus vaccine, split virus, 6-35 months dosage, for intramuscular or jet injection use
90658Influenza virus vaccine, split virus, 3 years and above dosage, for intramuscular or jet injection use
90659Influenza virus vaccine, whole virus, for intramuscular or jet injection use
90660Influenza virus vaccine, live, for intranasal use
90675Rabies vaccine, for intramuscular use
90676Rabies vaccine, for intradermal use
90680Rotavirus vaccine, tetravalent, live, for oral use
Editors Note: We will cover these new immunization codes more in future issues of PCA.
In addition, the CPT verbiage for some other vaccines has been revised. Here are the revised immunization codes.
90700Diphtheria, tetanus toxoid, and acellular pertussis vaccine (DTaP), for intramuscular use
90701Diphtheria, tetanus toxoid, and whole cell pertussis vaccine (DTP), for intramuscular use
90702Diphtheria and tetanus toxoid (DT) adsorbed for pediatric use, for intramuscular use
90703Tetanus toxoid adsorbed, for intramuscular or jet injection use
90704Mumps virus vaccine, live, for subcutaneous or jet injection use
90705Measles virus vaccine, live, for [...]
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