Most primary care pediatricians use Current Procedural Terminology (CPT®) codes 90460 and 90461 on a daily basis. However, questions about these immunization administration codes continue. In this article, we address a few questions related to the basic CPT instructions for reporting immunization administration and related diagnosis codes.
First, here are the codes for immunization administration.
Only report codes 90460 and 90461 when all of the following conditions are met:
If the patient is 19 years or older or counseling is not provided by a physician or other QHP, report codes 90471–90474.
Code 90471 or 90473 is reported for the first or only vaccine/toxoid product administered when counseling by a physician or other QHP is not provided. Any additional immunizations provided without counseling would be reported with 90472 or 90474 based on the method of administration. Only one first administration code, 90471 or 90473, is reported...