Wiki 90471 in 22 place of service

[nikki_coder]

has anyone else had problems getting reimbursed for vaccine administrations done in an outpatient setting (22 place of service)?

 

[mitchellde]

In an outpatient setting the physician would not be billing for the administration or the vaccine since the administration is performed by hospital staff. So are you billing fir the facility?

 

[nikki_coder]

we are billing for the professional fee. so are you saying that the administration should be submitted on the facility side?

 

[mitchellde]

Yes. It is their staff that performs the administration and their vaccine supply. There is nothing for the physician to bill when the patient comes in just for a vaccine, when you are a 22 POS.

 

[nikki_coder]

thank you for your comments, I appreciate it. we are actually billing the professional services of NPs. it is them that are administering the vaccine. not a nurse or assistant.

 

[mitchellde]

You will find it difficult to be paid for this service in an outpatient setting. The question is then who pays the NP. Does it come as a salaried hospital employee or out of the physician office budget. Or perhaps you should be using the 90460 instead?

 

[nikki_coder]

they are employed and paid by hospital. what is the difference between the 90471 and the 90460 except for the counseling? thank you!

 

[mitchellde]

If the NP is employed and paid by the facility then the facility bills the service not the physician office. The counseling would be something the provider office could bill for. However you stated that the NPs are facility employees. Do you also have a physician that you bill for?