Primary Care Coding Alert

Answer: Chris Shaw, CPC, accounts receivable representative for Health Access Network, which does the billing for the physician practices of Crozer Keystone Health Network in Chester, Pa., suggests you create a special write-off code for the vaccines. She says this allows you to track how many children take advantage of the Federal program. You should still code for the vaccines even though the drugs are provided by Medical Assistance and will not be reimbursed. The appropriate codes for common vaccinations are 90710 (measles, mumps, rubella and varicella vaccine [MMRV], live, for subcutaneous use); 90701 (diphtheria, tetanus toxoids, and whole cell pertussis vaccine [DPT], for intramuscular use), and 90712 (poliovirus vaccine, [any types(s)] [OPV], live, for oral use). In Minnesota, she also uses modifier XV, which indicates that the clinic is part of the Minnesota Vaccination Program. Check with your local carrier for the appropriate state code.

Dont forget to use the administrative codes, reminds Carla Bliese, CPC, a procedural coder for Silverlake Clinic Professional Associates, a 13-provider family practice in Minneapolis. Those codes are 90471 (immunization administration [includes percutaneous, intradermal, subcutaneous, intramuscular and jet injections and/or intranasal or oral administration]; one vaccine [single or combination vaccine/toxoid]), and 90472 (each additional vaccine [single or combination vaccine/toxoid]). Bliese charges one penny for the vaccines just so they are sure to be tracked in her offices accounts department.