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   RE: Vaccine Coding
 From: Kathy Saradarian
 To: Member Forum
 Posted: 10-26-2017 17:31
For a Td or Tdap I bill the appropriate CPT code for the vaccine and a 90471 if it's the only vaccine given or a 90472?? if another vaccine?? is given.?? The DX code for all vaccines is Z23.?? (The V codes are ICD9 and are gone).?? I get paid for the vaccine and an administration code by everyone but Certain Medicaid patients that are covered by VFC and therefore you can't get reimbursed for the vaccine but you should be able to get covered for the administration.

Who isn't paying you?
--  Kathy Saradarian, MD Solo since 2003 Always Private, Small Group since 1990 Practice Partner since 2003 Branchville, NJ

------Original Message------

Kathy and Mamatha,

Thank you for responses.

Just to be clear.....for adults you are billing 90471 and 90472, with routine Td and Tdap, and being reimbursed for both administration codes by some  HMOs, PPOs, blues, etc.?

For adults are you using V03.7?   I believe z23 is for children less than 7.

I realize with Medicare, these codes are not reimbursed by Part B in the office unless they are associated with an acute laceration, etc.

Thanks again.

Michael S. MD

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