For combination vaccines that may involve counseling on as many as five different vaccines, getting paid as though the physician counseled on only one vaccine never seemed fair. CPT 2011 must recapture that extra counseling work and say goodbye to those problem issues.
Combination vaccine such as pencil cell involve counseling on each product but currently allow payment for only one counseling administration code. Since the current CPT vaccine administration codes 90645 to 90467 are coded for vaccine, the physician does not receive additional payment for the additional counseling work associated with multiple components that are included in one product.
Multiple component vaccines like Pentacel, Kinrix, MMRV have had an economic disinvite related to the loss of immunization administration codes with these vaccines.
The new vaccines will solve these problems by being based on the number of components. CPT does this by deleting codes 90465 to 9468.
The 90471 to 9047 CPT codes however will remain the same. So when there's no counseling involved with vaccine administration, you will use those codes as you have been.
You'll be able to use medicine service series vaccine administration with counseling codes on older patients and when a nurse provides the counseling. Because counseling for adolescents can involve as much time as counseling on vaccines for younger children especially true when you have something like Gardasil. The American Academy of Pediatrics recommended that the age from the patient on the vaccine administration with counseling codes berate.
New CPT codes 90460 and 90461 extend vaccine administration with counseling to patients through 18 years of age. Busy practices will be thrilled at being able to use their registered nurses or licensed practicing nurses to capture the higher relative value units that some private payers associate with vaccine administration with counseling code.
The new vaccine administration with counseling code descriptor expands who can provide the vaccine counseling that was just from what was described in the deleted immunization administration with vaccine counseling codes.
CPT 2011 vaccine administration with counseling codes 90465 to 90468 limited the counsel’s role to a physician and subject to state scope of practice laws to non-physician practitioner, NPs or physician assistants, PA.
The new vaccine administration with counseling codes extend the counseling opportunity to any qualified healthcare professional practicing within his or her state described scope of practice.
There are no further guidelines that have come out about how CPT defines on other qualified healthcare professional.
From now, depending on state scope of practice laws circulating that an RN, LPN or medical technician could provide the counseling and the practice could still use the vaccine administration with counseling code.
CPT streamlines your coding of the vaccine as counseling CPT codes by giving you one universal base code. The code includes any route of administration meaning you no longer have to choose a different code based on whether the code is intramuscular subcutaneous or oral intranasal.
For complete and up to date information on family practice coding and billing, visit family practice coding and billing page