Pediatric Coding Alert

Question: After reading your informative articles on the vaccine coding for 2011, I have a follow-up question about performing and reporting vaccines. If we administer a vaccine for DTaP, we would report 90700, 90460x1, and  90461x2? And if we administer a Kinrix (DTaP-IPV) vaccination, do we report 90696, 90460x1, and 90461x3? Finally, if we administer Pentacel (DTaP-Hib-IPV), should we report 90698, 90460x1, and 90461x4?

Kentucky Subscriber

Answer: Yes, you are billing correctly by linking the immunization administration code with each specific multiple component and combination vaccine by reporting your claim as follows:

DTaP

• 90700 -- Diphtheria, tetanus toxoids, and acellular pertussis vaccine (DTaP), when administered to individuals younger than 7 years, for intramuscular use
• 90460x1 -- Immunization administration through 18 years of age via any route of administration, with counseling by physician or other qualified health care professional; first vaccine/toxoid component
• 90461x2 -- ...each additional vaccine/toxoid component

Kinrix

• 90696 -- Diphtheria, tetanus toxoids, acellular pertussis vaccine and poliovirus vaccine, inactivated (DTaP-IPV), when administered to children 4 through 6 years of age, for intramuscular use
• 90460x1
• 90461x3

Pentacel

• 90698-- Diphtheria, tetanus toxoids, acellular pertussis vaccine, haemophilus influenza Type B, and poliovirus vaccine, inactivated (DTaP - Hib - IPV), for intramuscular use
• 90460x1
• 90461x4