Primary Care Coding Alert

Question: When an adult patient receives a DECAVAC injection, should I use 90714 or 90718? Which diagnosis code should I report?


New Jersey Subscriber


Answer: You should use 90714 (Tetanus and diphtheria toxoids [Td] adsorbed, preservative-free, for use in individuals 7 years or older, for intramuscular use) in addition to 90465-90474 (Immunization administration ...) when staff use DECAVAC from Sanofi Aventis.

Although both 90714 and 90718 describe toxoids containing tetanus and diphtheria (Td), the first code denotes the preservative-free version, and the second  code represents the regular product. For non-preserva-tive-free Td products, assign 90718 (Tetanus and diphtheria toxoids [Td] adsorbed for use in individuals 7 years or older, for intramuscular use).

Watch out: Although CPT added 90714 in 2006, the code became effective July 1, 2005. Medicare carriers and intermediaries must use the new code for services previously billed under code 90718, CMS says in MLN Matters Number: MM4222 available at www.cms.hhs.gov/MLNMattersArticles/downloads/MM4222.pdf. The implementation for this article is Oct. 2, 2006. 

Link the vaccine administration and product code to the reason for TD administration:

- Use V06.5 (Need for prophylactic vaccination and inoculation against combinations of diseases; tetanus-diphtheria [Td] [DT]) for preventive vaccination (as a routine booster every 10 years throughout life for patients 7 years of age or older who have received a primary series of tetanus- and diphtheria-containing vaccine).

- Use a wound care diagnosis (such as 892.0, Open wound of foot except toe[s] alone; without mention of complication) for therapeutic administration (in persons who have not received a tetanus toxoid-containing preparation within the preceding five years).