Use Medicine Series Vaccine Administration with Counseling Codes On Older Patients

By now, we all are aware that CMS has created HCPCS codes (Q2035, Q2036, Q2037, Q2038, and Q2039) and payment allowances to replace 90658. Apart from this, you will be able to use medicine series vaccine administration with counseling codes on older patients and when a nurse provides the counseling, thanks to CPT 2011. Since counseling for adolescents can involve as much time as counseling on vaccines for younger children, the American Academy of Pediatrics suggested that the age limitation on the vaccine administration with counseling codes be raised. Just-in codes extend vaccine administration with counseling to patients through 18 years of age.

Busy practices will be excited at being able to use their registered nurses (RN) or licensed practicing nurses (LPN) to capture the higher RVU some private payers associate with the vaccine administration with counseling. The just-in vaccine administration with counseling code descriptor expands who can provide the vaccine counseling described in the deleted immunization administration with vaccine counseling codes (90465-90468). Last year's CPT vaccine administration with counseling codes 90465-90468 limited the counselor role to a physician and, subject to state scope of practice laws, nurse practitioner or physician assistant.

The just-in administration with counseling code extend the counseling opportunity to any "qualified health care professional" practicing within his/her state described scope of practice. An RP, LPN or medical technician could provide the counseling and the practice could still use the vaccine administration along with counseling code.

On a concluding note, you should remember the just-in administration codes - 90460 and 90461 are per vaccine/toxoid component. This means that if your doctor provides counseling and administration for a combination vaccine such as MMR, you will report 90460 for the first component and 90461 for each additional component. In the MMR example, you'd code 90460 once and 90461 twice. You'd report only a single vaccine administration code for a combination vaccine irrespective of the number of components prior to this year.

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