Just be careful that 90465 - 90468 are only used when a physician provides face to face counseling along with the vaccination. (for patients under 8 years old, also...) You would use the vaccine/toxoid admin codes 90465 - 90474 if the injection is for an actual vaccine or toxoid product, which are listed as CPT codes listed a little bit after 90474. (Like Varicella Vaccine, 90716, or influenza vaccine, 90658). If multiple vaccines are being given, only list 1 "first vaccine" code (one with an odd# - which one depends on the method of administration, either shot, or oral/nasal), and all the rest are the subsequent "each additional" codes. For most commercial payers, no modifier is required to list multiple vaccines. If you're injecting something else - like a drug that requires a J-code (Rocephin, J0696, for example), then you would use 96372. I would suggest appending 96372 with a 59 modifier if you're billing it along side vaccine administrations for commercial insurance. If you bill multiple 96372's, it's better to bill them out as separate single unit line items, and use 59 modifiers on all of the extra ones (after the first 96372). Otherwise they might deny as "exceeding typical daily frequency". If you bill a 96372 with an office visit, there are 2 things to always remember: 1. you can't bill a 99211 with a 96372. 2. Any other E/M code will require a 25 modifier to keep it from bundling to 96372. We see a ton of denials that pertain to this issue on the follow up side, but 9 times out of 10, it's an easy fix...hope that's helpful!
