Pediatric Coding Alert

Question: What diagnoses should we use when administering multiple immunizations? We use V20.2 for 90471 and 90472, V05.3 for 90731 and V03.82 for 90669.

Alaska Subscriber

Answer: Code V20.2 (routine infant or child health check) is for a well-child visit only and should not be used with immunizations. Additionally, 90731 has been deleted in favor of 90744 (hepatitis B vaccine, pediatric/adolescent dosage [3 dose schedule], for intramuscular use). For this vaccine, use ICD-9 code V05.3 (need for other prophylactic vaccination and inoculation against single diseases; viral hepatitis). With 90669 (pneumococcal conjugate vaccine, polyvalent, for children under five years, for intramuscular use), you are correct to use V03.82 (need for prophylactic vaccination and inoculation against bacterial diseases; other specified vaccinations against single bacterial diseases; streptococcus pneumoniae [pneumococcus]).

You should also use V05.3 and V03.82 to support the administration codes (90471, 90472). Code 90471 describes administration of one vaccine, and 90472 describes administration of each subsequent vaccine. Therefore, it doesnt matter which administration code you link to each of the diagnosis codes, providing they match up with the diagnosis codes for the injections themselves. If you perform a preventive medicine service at the same time, link V20.2 to the appropriate procedure code (99381, 99382, 99391 or 99392).