Wiki Coding For Rabies Vaccination??

[elizabeth24]

Patient came to the ER after sustaining a bite from a bat. Patient is now receiving a series of rabies vaccinations. I am trying to figure out how to best code this. There is Z20.3 which is contact with and suspected exposure to rabies, Z23 which just states patient is coming in for an encounter for a vaccination, and there is Z29.14 which is encounter for prophylactic rabies immune globin. I am not sure what the guidelines for prophylactic would be. Thanks in advance!

 

[renee dustman]

Check the payer's guidelines but this BCBS of NC probably holds true for most payers: https://www.bluecrossnc.com/sites/d...dfs/medicalpolicy/immunization_guidelines.pdf

 

[elizabeth24]

Thank you!! I still have not figured out the best code but as far as I know insurance has paid. I would assume since the patient was bitten by a bat it is more for exposure, even though there is no way of actually knowing if the bat had rabies.

 

[ivorytofu@hotmail.com]

Thank you!! I still have not figured out the best code but as far as I know insurance has paid. I would assume since the patient was bitten by a bat it is more for exposure, even though there is no way of actually knowing if the bat had rabies.

If the pt is bitten by a bat or any animal the first time the pt is seen the bite would be coded primary, the exposure to rabies, and the external cause. For subsequent visits where the pt is only receiving the prophylactic vax you would code the exposure primary and the prophylactic vax as secondary you would not code Z23 at all.

 

[terryg351@hotmail.com]

When a parent brings in the vaccines: 90691 typhoid and 90675 rabies; how should this be coded.? We received a denial for 90460 dx z23. The 90691 and 90675 was not billed but noted in the patient's ledger as 0.01.