1032 APPENDIX II­— CODES FOR COMMONLY ADMINISTERED PEDIATRIC VACCINES/ 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 Terminology (CPT) code to indicate which immunization product was administered to the patient. A regularly updated listing of CPT product codes for commonly adminis- tered pediatric vaccines can be found at www.aap.org/en-us/Documents/cod- ing_vaccine_coding_table.pdf. CPT codes for vaccine administrations are reported in addition to the CPT codes for specific vaccines and toxoid products. Codes 90460 and 90461 are only reported when the physician 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. The 90460 code should be used for each vaccine administered. For vaccines with multiple components, code 90460 should be reported in conjunction with code 90461 for each additional component in a given vaccine (eg, DTaP admin- istration would include 90460 x 1 and 90461 x 2). Multivalent antigens 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). Without counseling by the physician or qualified healthcare professional, the administration codes 90471– 90474 are used, depending on the number of vaccines administered and the route of administration. ICD-10-CM has only a single diagnosis code for reporting vaccines, Z23. When reporting vaccines administered, ICD-10 requires use of code Z23 regardless of the reason for the encounter. For example, if vaccines are given as part of a childhood pre- ventive care visit, code Z23 should be reported in addition to code Z00.121 (encounter for routine child health examination). Immune Globulin products are not considered vaccines, and the administration code 96372, therapeutic injection given intramuscularly or subcutaneously, should be used. For Rabies Immune Globulin and rabies vaccine administration, code 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 surround- ing the injury, including type of animal involved (ie, codes found in the V-Y categories). The ICD-10 code Z29.14, encounter for prophylactic rabies immunoglobulin, can also be used. For RSV Immune Globulin, 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. Red_Book_2020_APPENDIX_1027-1060.indd 1032 19/02/21 10:05 AM
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