How To Use CPT Code 90471

CPT 90471 describes the administration of immunization using percutaneous, intradermal, subcutaneous, or intramuscular injections for a single vaccine or combination vaccine/toxoid. This article will cover the description, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information, similar codes and billing examples.

1. What is CPT Code 90471?

CPT 90471 can be used to describe the administration of immunization using various routes such as percutaneous, intradermal, subcutaneous, or intramuscular injections. This code is used when a healthcare provider administers a single vaccine or combination vaccine/toxoid to a patient to increase their immunity against a specific disease.

2. Official Description

The official description of CPT code 90471 is: ‘Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections); 1 vaccine (single or combination vaccine/toxoid).’ It is important to note that CPT code 90471 should not be reported in conjunction with CPT code 90473.

3. Procedure

1. The healthcare provider prepares the patient for immunization.
2. The provider administers a single vaccine or a combination of vaccines or toxoids using percutaneous, intradermal, subcutaneous, or intramuscular routes.

4. Qualifying circumstances

CPT 90471 is applicable when a patient requires immunization to increase their immunity against a specific disease. The patient may receive a single vaccine or a combination of vaccines or toxoids. The healthcare provider must administer the immunization using percutaneous, intradermal, subcutaneous, or intramuscular injections.

5. When to use CPT code 90471

CPT code 90471 should be used when a healthcare provider administers a single vaccine or combination vaccine/toxoid to a patient using percutaneous, intradermal, subcutaneous, or intramuscular injections. It is important to note that CPT code 90471 should not be reported with CPT code 90473.

6. Documentation requirements

To support a claim for CPT 90471, the healthcare provider must document the following information:

• Patient’s diagnosis or reason for immunization
• Specific vaccine or combination of vaccines/toxoids administered
• Date and time of the immunization
• Route of administration (percutaneous, intradermal, subcutaneous, or intramuscular)

7. Billing guidelines

When billing for CPT 90471, ensure that the healthcare provider administers a single vaccine or combination vaccine/toxoid using percutaneous, intradermal, subcutaneous, or intramuscular injections. If multiple vaccines are administered, use CPT code 90472 for each additional vaccine or toxoid component. It is important to follow the guidelines provided by the payer and report the services accurately.

8. Historical information

CPT 90471 was added to the Current Procedural Terminology system on January 1, 1999. Since then, there have been several changes to the code, including updates to the description and terminology. The most recent change occurred on January 1, 2010.

9. Examples

1. A healthcare provider administers a flu vaccine to a patient using a subcutaneous injection.
2. A nurse administers a measles, mumps, and rubella (MMR) vaccine to a child using an intramuscular injection.
3. A physician administers a tetanus toxoid vaccine to a patient using an intradermal injection.
4. A healthcare provider administers a hepatitis B vaccine to a patient using a percutaneous injection.
5. A nurse administers a pneumococcal vaccine to an elderly patient using a subcutaneous injection.
6. A physician administers a diphtheria, tetanus, and pertussis (DTaP) vaccine to an infant using an intramuscular injection.
7. A healthcare provider administers a human papillomavirus (HPV) vaccine to a teenager using an intradermal injection.
8. A nurse administers a varicella vaccine to a child using a percutaneous injection.
9. A physician administers a polio vaccine to a patient using an intramuscular injection.
10. A healthcare provider administers a meningococcal vaccine to a college student using a subcutaneous injection.