New Pediatric Immunization Codes Released for 2011: CPT® Codes 90460 and 90461
Effective with date of service Jan. 1, 2011, there are new CPT codes for immunization administration and counseling, 90460 and 90461. These codes replace CPT codes 90465 through 90468. The code descriptors for CPT codes 90460 and 90461 are as follows:
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 |
|
90461 + (add on code) |
Immunization administration through 18 years of age via any route of administration, with counseling by physician or other qualified health care professional; each additional vaccine/toxoid component. |
Example:
| Vaccine Code |
Descriptor |
# of |
Administration Codes |
|---|---|---|---|
|
90670 |
Pneumococcal Conjugate Vaccine |
1 |
90460 x 1 |
|
90723 |
Diphtheria, Tetanus Toxoids, Acellular Pertussis, Hepatitis B, Poliovirus Vaccine (DtaP-HepB-IPV) |
5 |
90460 x 1 |
|
90655 |
Influenza Virus Vaccine |
1 |
90460 x 1 |
If billed separately this would result in three lines of 90460, four lines of 90461 plus the additional three lines for the immunization itself.
To receive proper reimbursement, this claim should list multiple units for each code:
- 90460 x 3 units
- 90461 x 4 units
- Then add each appropriate vaccination code
Note: Please note that, due to the short time frame between notification of these new codes and their effective date, Blue Cross and Blue Shield of Texas continues to work on system enhancements to administer this multiple vaccine administration.
