Procedure Code 90669 and 90471

The other day a seasoned medical biller and coder emailed me an example that she was flagged with. She has two coding softwares to compare from and 1 software didn't mention she needed to bill the 90669 with the Admin charge while the other software told her she needed to add the Admin Charge.



She emailed me the sceanrio and asked me for my position on this edit. I emailed her the following:



I show that the Practice Management Software Claim Inspector edits are correct and that you can bill for the 90471 or 90472 Admin Injection codes. Explained as: Codes 90476 – 90748 identify the vaccine product ONLY. To report the administration of a vaccine/toxoid, the vaccine/toxoid product codes 90476 – 90749 must be used in addition to an immunization administration code(s) 90465-90474. Do not append modifier 51 to the vaccine/toxoid product codes 90476-90749.

She emailed me back that she had called Texas Medicaid and they verified she can bill with the Admin Codes.

I am adding this to my blog to remind others to never be afraid to ask questions or just "bounce" questions off of others. This is also a reminder that as nice as it is to have coding software they aren't always perfect.

The grouping of codes we reviewed were:
90476 - Adenovirus vaccine, type 4, live, for oral use
90477 - Adenovirus vaccine, type 7, live, for oral use
90581 - Anthrax vaccine, for subcutaneous use
90585 - Bacillus Calmette - Guerin vaccine (BCG) for tuberculosis, live, for percutaneous use
90586 - Bacillus Calmette-Guerin vaccine (BCG) for bladder, cancer, live, for intravesical use
90632 - Hepatitis A vaccine, adult dosage, for intramuscular use
90633 - Hepatitis A vaccine, pediatric/adolescent dosage-2 dose schedule, for intramuscular use
90634 - Hepatitis A vaccine, pediatric/adolescent dosage-3 dose schedule, for intramuscular use
90636 - Hepatitis A and hepatitis B vaccine (HepA-HepB), adult dosage, for intramuscular use
90645 - Hemophilus influenza b vaccine (Hib), HbOC conjugate (4 dose schedule), for intramuscular use
90646 - Hemophilus influenza b vaccine (Hib), PRP-D conjugate, for booster use only, intramuscular use
90647 - Hemophilus influenza b vaccine (Hib), PRP-OMP conjugate (3 dose schedule), for intramuscular use
90648 - Hemophilus influenza b vaccine (Hib), PRP-T conjugate (4 dose schedule), for intramuscular use
90649 - Human Papilloma virus (HPV) vaccine, types 6, 11, 16, 18 (quadrivalent), 3 dose schedule, for intramuscular use
90650 - Human Papillomavirus (HPV) vaccine, types 16 and 18, bivalent, 3 dose schedule, for intramuscular use
90655 - Influenza virus vaccine, split virus, preservative free, when administered to children 6-35 months of age, for intramuscular use
90656 - Influenza virus vaccine, split virus, preservative free, when administered to individuals 3 years and older, for intramuscular use
90657 - Influenza virus vaccine, split virus, when administered to children 6-35 months of age, for intramuscular use
90658 - Influenza virus vaccine, split virus, when administered to individuals 3 years of age and older, for intramuscular use
90660 - Influenza virus vaccine, live, for intranasal use
90661 - Influenza virus vaccine, derived from cell cultures, subunit, preservative and antibiotic free, for intramuscular use
90662 - Influenza virus vaccine, split virus, preservative free, enhanced immunogenicity via increased antigen content, for intramuscular use
90663 - Influenza virus vaccine, pandemic formulation
90665 - Lyme disease vaccine, adult dosage, for intramuscular use
90669 - Pneumococcal conjugate vaccine, polyvalent, when administered to children younger than 5 years, for intramuscular use
90675 - Rabies vaccine, for intramuscular use
90676 - Rabies vaccine, for intradermal use
90680 - Rotavirus vaccine, pentavalent, 3 dose schedule, live, for oral use
90681 - Rotavirus vaccine, human, attenuated, 2 dose schedule, live, for oral use
90690 - Typhoid vaccine, live, oral
90691 - Typhoid vaccine, Vi capsular polysaccharide (ViCPs), for intramuscular use
90692 - Typhoid vaccine, heat- and phenol-inactivated (H-P), for subcutaneous or intradermal use
90693 - Typhoid vaccine, acetone-killed, dried (AKD), for subcutaneous use (U.S. military)
90696 - Diphtheria, tetanus toxoids, acellular pertussis vaccine and poliovirus vaccine, inactivated (DTaP-IPV), when administered to children 4 years through 6 years of age, for intramuscular use
90698 - Diphtheria, tetanus toxoids, acellular pertussis vaccine, haemophilus influenza Type B, and poliovirus vaccine, inactivated (DTaP - Hib - IPV), for intramuscular use
90700 - Diphtheria, tetanus toxoids, and acellular pertussis vaccine (DTaP), when administered to individuals younger than 7 years, for intramuscular use
90701 - Diphtheria, tetanus toxoids, and whole cell pertussis vaccine (DTP), for intramuscular use
90702 - Diphtheria and tetanus toxoids (DT) adsorbed when administered to individuals younger than 7 years, for intramuscular use
90703 - Tetanus toxoid adsorbed, for intramuscular use
90704 - Mumps virus vaccine, live, for subcutaneous use
90705 - Measles virus vaccine, live, for subcutaneous use
90706 - Rubella virus vaccine, live, for subcutaneous use
90707 - Measles, mumps and rubella virus vaccine (MMR), live, for subcutaneous use
90708 - Measles and rubella virus vaccine, live, for subcutaneous use
90710 - Measles, mumps, rubella, and varicella vaccine (MMRV), live, for subcutaneous use
90712 - Poliovirus vaccine, (any type[s]) (OPV), live, for oral use
90713 - Poliovirus vaccine, inactivated (IPV), for subcutaneous or intramuscular use
90714 - Tetanus and diphtheria toxoids (Td) adsorbed, preservative free, when administered to individuals 7 years or older, for intramuscular use
90715 - Tetanus, diphtheria toxoids and acellular pertussis vaccine (Tdap), when administered to individuals 7 years or older, for intramuscular use
90716 - Varicella virus vaccine, live, for subcutaneous use
90717 - Yellow fever vaccine, live, for subcutaneous use
90718 - Tetanus and diphtheria toxoids (Td) adsorbed when administered to individuals 7 years or older, for intramuscular use
90719 - Diphtheria toxoid, for intramuscular use
90720 - Diphtheria, tetanus toxoids, and whole cell pertussis vaccine and Hemophilus influenza B vaccine (DTP-Hib), for intramuscular use
90721 - Diphtheria, tetanus toxoids, and acellular pertussis vaccine and Hemophilus influenza B vaccine (DtaP-Hib), for intramuscular use
90723 - Diphtheria, tetanus toxoids, acellular pertussis vaccine, Hepatitis B, and poliovirus vaccine, inactivated (DtaP-HepB-IPV), for intramuscular use
90725 - Cholera vaccine for injectable use
90727 - Plague vaccine, for intramuscular use
90732 - Pneumococcal polysaccharide vaccine, 23-valent, adult or immunosuppressed patient dosage, when administered to individuals 2 years or older, for subcutaneous or intramuscular use
90733 - Meningococcal polysaccharide vaccine (any group(s)), for subcutaneous use
90734 - Meningococcal conjugate vaccine, serogroups A, C, Y and W-135 (tetravalent), for intramuscular use
90735 - Japanese encephalitis virus vaccine, for subcutaneous use
90736 - Zoster (shingles) vaccine, live, for subcutaneous injection
90740 - Hepatitis B vaccine, dialysis or immunosuppressed patient dosage (3 dose schedule), for intramuscular use
90743 - Hepatitis B vaccine, adolescent (2 dose schedule), for intramuscular use
90744 - Hepatitis B vaccine, pediatric/adolescent dosage (3 dose schedule), for intramuscular use
90746 - Hepatitis B vaccine, adult dosage, for intramuscular use
90747 - Hepatitis B vaccine, dialysis or immunosuppressed patient dosage (4 dose schedule), for intramuscular use
90748 - Hepatitis B and Hemophilus influenza b vaccine (HepB-Hib), for intramuscular use
90749 - Unlisted vaccine/toxoid

Immunization Administration for Vaccines/Toxoids
Codes 90465 - 90474 must be reported in addition to the vaccine and toxoid code(s) 90476-90749.

Report codes 90465-90468 only when the physician provides face-to-face consulting of the patient and family during the administration of a vaccine. For any immunization administration of any vaccine that is not accompanied by the face-to-face physician counseling to the patient/family report codes 90471-90474.

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