Primary Care Coding Alert

Question: I am getting an error message to remove code 96372 for vaccine administration for adults on Medicaid. Is the code correct, or should I be using another code?

South Carolina Subscriber

Answer: The error message is correct. CPT^® code 96372 (Therapeutic, prophylactic, or diagnostic injection (specify substance or drug); subcutaneous or intramuscular) should only be used when your provider administers therapeutic, prophylactic, or diagnostic drugs as the descriptor says. For subcutaneous or intramuscular vaccine administration, you should generally use 90471 (Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections); 1 vaccine (single or combination vaccine/toxoid)) for adults.

Remember: You will see different codes for COVID-19 vaccine administration, which will vary based on the specific COVID-19 vaccine administered and whether it’s the first or second dose (for those COVID vaccines that require more than one dose).