Coronavirus: AMA releases new CPT code for antigen tests

The American Medical Association (AMA) has a release an update to the Current Procedural Terminology (CPT) which includes a new code for reporting antigen testing of patients suspected to be…

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CPT 2011: Goodbye 90465-90474, Hello Vaccine Administration Component Coding

You’ll soon capture counseling per disease.

For combination vaccines that may involve counseling on as many as five different diseases, getting paid as though you counseled on one never seemed fair, but CPT 2011 lets you capture that extra counseling work.

Although multiple component vaccines require counseling on each disease, physicians have only been able to capture counseling for vaccine administration once per administration. CPT 2011 solves the problem with new immunization administration with counseling codes that you’ll code per vaccine component. 

CPT 2011 deletes 90465-90468 (Immunization administration younger than 8 years of age … when the physician counsels the patient/family … per day). Codes 90471-90474 (Immunization administration …) remain.

Use 90460 as Vaccine Administration With Counseling Base Code

No more looking at administration route when choosing which immunization administration with counseling code. For vaccine administration, you’ll assign one code for each vaccine’s initial component:

  • 90460 — Immunization administration through 18 years of age via any route of administration, with counseling by physician or other qualified health care professional; first vaccine/toxoid component.

 Definition: A component refers to the antigen in a vaccine that prevents disease caused by one organism.

CPT streamlines your coding of the vaccine counseling codes by giving you one universal base code. The code includes “any route of administration.” You no longer have to choose a different code based on whether the code is intramuscular/subcutaneous or oral/intranasal.

 Step 2:  Report Second Vaccine Component With +90461

Coders can breathe a sigh of relief as the complexities over deciding which 90465-90468 code to use as the base code will soon end. CPT 2011 gives you only one vaccine administration with counseling base code (90460). For each additional vaccine component, you report the same add on code:

  • +90461 — Immunization administration through 18 years of age via any route

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EHR Incentive Program Enrollment Starts Soon

CMS clears up flu shot coding confusion.

You’ve heard the advantages of participating in CMS’s Electronic Health Record (EHR) Incentive Program (including $44,000 per-physician bonus incentives over a five-year period), but you may not be sure how to enroll.

CMS staffers cleared up that confusion during an Oct. 5 open door forum, where CMS’s Rachel Maisler indicated that you must register on CMS’s EHR incentive program’s Web site, which will open in January 2011 for the Medicare program.

In addition, you must be enrolled in CMS’s PECOS system and have an NPI, and you must use certified EHR technology. You can find details on how to determine which EHR systems are certified on www.healthit.hhs.gov.

Key dates: During the call, CMS reps also announced important dates involved in EHR participation. “Attestation, which is how you will report the objectives and measures for meaningful use and clinical quality measures, will begin in April of 2011, and we expect the first payments will be made in May of 2011,” Maisler said.

Look for Combined Flu Shot

Flu vaccine: Now that the H1N1 immunization is part of the regular flu vaccine, a caller asked the CMS officials whether a new code will be developed to describe the combined flu shot, but CMS officials noted that no such code will be issued.

“We’re continuing to use the same codes as last year, and my understanding is the H1N1 is part of the regular flu vaccine this year, so you’d bill what the appropriate flu vaccine code is,” said CMS’s Amy Bassano, during the call. High-dose flu vaccine code 90662 (Influenza virus vaccine, split virus, preservative free, enhanced immunogenicity via increased antigen content, for intramuscular use) has been added to the roster of codes that can be billed to Medicare, Bassano confirmed.

RACs: Another caller...

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