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How to bill if a patient receives two vaccines on the same date: The first is administered by injection and the second is administered orally

Confusion arises for both payers and providers when the patient requires multiple vaccines on the same date, but administered via different methods. In this scenario, report one vaccine administration code that indicates “first,” and report the other route as an additional vaccine. For example, a patient is receiving injectable hepatitis B vaccine and intranasal influenza vaccine. Report the vaccine administration using 90471 Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections) and +90474 Immunization administration by intranasal or oral route; each additional vaccine (single or combination vaccine/toxoid) (List separately in addition to code for primary procedure), for the intanasal influenza vaccine. Even though the intranasal vaccine was given a different route, it is still considered the second or additional vaccine administered.

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