• If this is your first visit, be sure to check out the FAQ & read the forum rules. To view all forums, post or create a new thread, you must be an AAPC Member. If you are a member and have already registered for member area and forum access, you can log in by clicking here. If you've forgotten the password it can be reset on our sign in section by entering your registered Email Address or Username here. To start viewing messages, select the forum that you want to visit from the selection below..

Wiki Tetanus Vaccine

dballard2004

True Blue
Messages
1,316
Location
Overland Park, KS
Best answers
0
A patient came into to the clinic because they cut their finger on a cat food lid. The provider ordered a tetanus vaccine. There is some disagreement on what ICD-9 code we should use here. We agree that the finger cut should be coded from the 800 series for open wound, but does this cover the tetanus vaccine as well or should the V code for the vaccine be coded in addition? I say both should be used since a vaccine should be tied to the V code, but the provider thinks the code for the finger cut should cover the vaccine since this is the reason for the vaccine. Any thoughts? Thanks.
 
Dawson,

I agree with you...

When filing claims for 90702, 90703, 90714, or 90718, the primary diagnosis should be one of the ICD-9 "V" codes indicating the need for prophylactic vaccination against bacterial diseases or combinations of diseases (V03.7 Tetanus toxoid alone or V06.5 tetanus-diphtheria) plus an injury related ICD-9 code as the secondary diagnosis. Tetanus or tetanus-diphtheria (Td) toxoids adsorbed are only covered when directly related to the treatment of an injury/wound. For further instructions, please visit the Centers for Medicare Medicaid Services website to view the Internet Only Manuals (IOM) – Medicare Benefit Policy Manual (Pub 100-2, Chapter 15, Section 50.4.4.2 - Immunizations: http://www.cms.hhs.gov/Manuals/IOM/list.asp

This is Medicare's policy and we follow this across the board without any issues...
 
Top