APPENDIX II– CODES FOR COMMONLY ADMINISTERED PEDIATRIC VACCINES/ 1057 TOXOIDS AND IMMUNE GLOBULINS Appendix II Codes for Commonly Administered Pediatric Vaccines/Toxoids and Immune Globulins Vaccine, toxoid, and Immune Globulin codes use a specific vaccine Current Procedural Ter- minology (CPT) code to indicate which immunization product was administered to the pa- tient. A regularly updated listing of CPT product codes for commonly administered pedi- atric vaccines can be found at vaccine_coding_table.pdf. CPT codes for vaccine administrations are reported in addition to the CPT codes for specific vaccines and toxoid products. 90460 and 90461 are only reported when the phy- sician or other qualified health care professional provides face-to-face counseling during the encounter when a vaccine is administered to a patient through 18 years of age. Oth- erwise, the administration codes 90471–90474 are used, depending on the number of vaccines administered and the route of administration. The 90460 code should be used for each vaccine administered. For vaccines with multiple components, code 90460 should be reported in conjunction with 90461 for each additional component in a given vaccine (eg, DTaP administration would include 90460 + 90461 x 2). Multivalent anti- gens or multiple serotypes of antigens against a single organism are considered a single component of vaccines (eg, PCV-13 administration should use only one 90460). Immune Globulin products are not considered vaccines, and the administration code 96372, ther- apeutic injection given intramuscularly or subcutaneously, should be used. Unlike ICD-9, ICD-10-CM has only a single diagnosis code for reporting vaccines, Z23. When reporting vaccines administered, ICD-10 requires use of Z23 regardless of the reason for the encounter. For example, if vaccines are given as part of a childhood pre- ventive care visit, Z23 should be reported in addition to Z00.121 (encounter for routine child health examination). For Rabies Immune Globulin and rabies vaccine administration, Z20.3 (contact with and [suspected] exposure to rabies) should be reported as well as the ICD-10-CM codes describing the nature of the injuries and circumstances surrounding the injury, including type of animal involved (ie, codes found in the V-Y categories). For RSV Immune Globu- lin, palivizumab, the appropriate ICD-10-CM diagnoses of gestational age and/or other medical condition(s) that support the need to administer palivizumab should be reported.
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