cpt 90472, cpt code 90472, 90472 cpt code

CPT Code 90472 | Description, Procedure & Billing Guidelines (2022)

CPT 90472 is an add-on code that can be reported for every vaccine administered after the initial vaccine.

1. What Is CPT Code 90472?

CPT 90472 is an add-on code that covers every vaccine injection after the first injection. You can use this add-on code only as an addition to the primary injection CPT code.

2. Description

The CPT book describes add-on code 90472 as follows: “Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections); each additional vaccine (single or combination vaccine/toxoid) (List separately in addition to code for primary procedure).”

3. Procedure

The 90472 add-on code can be billed when a provider administers (an) additional injection(s) to a patient in the effort of making them immune to an infectious disease(s).

The provider administers an additional vaccine to a patient after the initial vaccine.

The vaccine can be administered;

  • intramuscular;
  • subcutaneous;
  • intradermal; or
  • percutaneous.

4. How To Use CPT 90472

The 90472 CPT code can only be used as an add-on code in combination with a CPT code for the initial vaccine. This code will be denied if it is not reported in combination with a primary code.

You can use 90472 together with;

You may not bill CPT code 90472 with CPT 91300, CPT 91301, CPT 91302, CPT 91305, CPT CPT 91306, CPT 91307, CPT 91309, CPT 91310, CPT 91311, CPT 91312, CPT 91313, CPT 91314, CPT 91315, or CPT 91316 unless both a severe acute respiratory syndrome coronavirus 2 [SARS-CoV-2] and one toxoid/vaccine product from CPT 90476 to CPT 90759 are administered during the same visit.

Look into CPT 90281 to CPT 90399 for immune globulin. To administer immune globulin, you can use CPT 96374, CPT 96371, CPT 96370, CPT 96368, CPT 96369, CPT 96367, CPT 96366, and CPT 96365.

You may want to use CPT 90586 and CPT 51720 for intravesical administration of the BCG vaccine.

5. Resources

CPT Professional 2022

https://www.mass.gov/doc/all-provider-bulletin-197-coverage-of-h1n1-and-seasonal-influenza-vaccinations/download

https://www.nd.gov/dhs/services/medicalserv/medicaid/docs/cpt/vaccines-toxoids.pdf

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