Pediatric Coding Alert

Answer: CPT 90471 is for the administration of one single or combination vaccine; 90472 is an add-on code to be used for each additional single or combination vaccine. You would never code 90472 without coding 90471 as well. If you are going to link the vaccine codes to the diagnosis code for well-child care (V20.2), you should use units: For three immunizations, code 90471 with one unit and 90472 with two units. Some insurance companies prefer units. But the American Academy of Pediatrics (AAP) recommends using each vaccine diagnosis code, linking the procedure codes (including administration codes) with those. In that case, you would not use units but rather would list 90471 for the first vaccine, and 90472 for each subsequent vaccine. Lets say a child came in for a four-month well-baby visit, and got DTAP, Hib and polio immunizations. You would use evaluation and management (E/M) code 99391 for the well-baby visit, 90700 for the DTaP vaccine, 90471 for the immunization administration (first vaccine), 90646 for the Hib, 90472 for the Hib administration, 90713 for the IPV, and 90472 for the IPV vaccine.