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Coding guidelines for DTaP vaccine

CDC – Childhood Immunization Schedule – Diphtheria and tetanus toxoids and acellular pertussis vaccine

Diphtheria and tetanus toxoids and acellular pertussis vaccine (DTaP) - Minimum age: 6 weeks

• The fourth dose of DTaP may be administered as early as age 12 months, provided 6 months have elapsed since the third dose.

• Administer the final dose in the series at age 4–6 years.

Coding information:

CPT: Report CPT 90700 for intramuscular use against diphtheria, tetanus, and pertussis (in acellular form-synthetic) for administration to children younger than 7 years of age. It is normally called as DTaP (Diphtheria, tetanus toxoids, and acellular pertussis vaccine)

Please make a note of vaccines and its respective CPT codes when DTaP vaccine is given intramuscularly combined with other vaccines.

Report CPT 90696 for intramuscular vaccine for diphtheria, tetanus toxoids, and acellular pertussis (synthetic form) combined with inactivated poliovirus vaccine, or DTaP-IPV, for administration to children 4 through 6 years of age.

Report CPT 90698 for immunization supply of diphtheria, tetanus toxoids, and acellular pertussis (synthetic form) vaccine, combined with haemophilus influenza Type B, and inactivated poliovirus vaccine, or DTaP-Hib-IPV, for intramuscular use.

Report CPT 90701 for intramuscular use against diphtheria, tetanus, and pertussis (in whole cell form), commonly called DTP. The DTaP/DTP vaccinations are routine immunizations for children.

Report any of the above applicable vaccine codes with the administration code CPT 90465 or CPT 90466 (if the vaccine is administered in addition to anyother vaccine).

ICD: Report any of the applicable ICD’s from the below list

V03.81 Need for prophylactic vaccination against hemophilus influenza type B (Hib)

V04.0 Need for prophylactic vaccination and inoculation against poliomyelitis

V06.1 Diphtheria-tetanus-pertussis, combined [DTP] [DtaP]

V06.5 Tetanus-diphtheria [Td] [DT]

V06.3 Need for prophylactic vaccination with diphtheria-tetanus-pertussis with poliomyelitis (DTP + polio) vaccine.

Reference:
http://www.cdc.gov/vaccines/pubs/vis/downloads/vis-dtap.pdf

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