Pedspal News
Cook Children's Health Care System and athenahealth Announce Nation's First 2D Barcode System for Vaccines
PedsPal, Cook Children's Health Care System's physician group’s purchasing program, has collaborated with athenahealth, Microsoft, Sanofi Pasteur, and Merck, as well as its physician members, to establish ... read more
Benefits of vaccine reimbursement
PedsPal medical director Jason Terk, M.D. discussing vaccine reimbursement and VaccineView.
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New Immunization Administration Codes
Dear Colleagues,
You may remember that effective 1/1/11, all of the IA with counseling codes (90465, 90466, 90467, 90468) are no longer valid and are replaced by 90460 and 90461 which are based on the number of components of each vaccine product; the non-counseling IA codes (90471, 90472, 90473, 90474) will be unchanged and still be based on the number of administrations and not components. All of the major commercial payers have made the necessary changes in their systems so we have to update what we submit for IA with counseling accordingly.
Unbelievably, Texas Medicaid informed the Texas Pediatric Society and the Texas Medical Association on 12/30/10 that they would not be prepared to accept the new IA with counseling codes and have instructed Medicaid providers to continue using the now invalid codes until further notice. Remember, no good deed goes unpunished and that certainly goes for those of us who try to our bit and see those kids on Medicaid!
Therefore, I offer a few points to note and remember:
- Each vaccine order potentially may indicate that either private vaccine or VFC vaccine was used; there are different codes used for VFC vaccine product and IA on the billing tab.
- Each vaccine order potentially may indicate that counseling by a physician or qualified non-physician provider occurred or not; there are different codes used for IA with counseling versus IA with no counseling (such as a nurse visit for immunization only) on the billing tab.
- Because Texas Medicaid is not ready to accept the new IA with counseling codes, we must use the old 90465-90468 codes when counseling occurs for any Texas Medicaid vaccine recipient until they get their act together.
Jason V. Terk, M.D.
Pedspal Medical Director
Cook Children's Physician Network
