Primary Care Coding Alert

Question: I'm new to family medicine coding and have a lot to learn. Can I bill 90658 along with 90471, or are they redundant?

North Dakota Subscriber

Answer: You can--and should--bill the codes together. Code 90658 (Influenza virus vaccine, split virus, when administered to individuals 3 years of age and older, for intramuscular use) captures the cost for the actual vaccine, and 90471 (Immunization administration [includes percutaneous, intradermal, subcutaneous, or intramuscular injections]; 1 vaccine [single or combination vaccine/toxoid]) represents the actual administration of the vaccine and related supply charges. You should always report an administration code for every vaccine your provider gives.

If the patient is age 18 or under and receives counseling from the physician (or other qualified health care professional) prior to vaccine administration, you should report 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) in lieu of 90471. If the vaccine in question has multiple components (e.g. 90707, Measles, mumps and rubella virus vaccine [MMR], live, for subcutaneous use) for which counseling is provided, then you will also report 90461 (...each additional vaccine or toxoid component administered [List separately in addition to code for primary procedure])