Medical Coding for Additional Vaccine Add On Codes

Laureen: (Additional Vaccine Add On Codes) – Q: “How do you code for the additional vaccine add-on code for vaccines that contain multiple components such as Pentacel?”

Chandra loves, loves answering chat questions, so normally by the time we get to this point, she’s answered them all. Is this one of them?

Chandra: I got through them all because usually you and Alicia are talking way more than I am. I have a list of all the questions but I’m trying to answer… I can answer this one, sure!

A: According to CPT, the guidelines say that: “A component refers to all antigens in a vaccine that prevent disease(s) caused by one organism. Multivalent antigens or multiple serotypes of antigens against a single organism are considered a single component of vaccines. Combination vaccines are those vaccines that contain multiple vaccine components. Conjugates or adjuvants contained in vaccines are not considered to be component parts of the vaccine as defined above.”

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When we start looking through here, the way that the codes break down is it is first or only component of each vaccine or toxoid administered, and then there’s an add-on code for each additional vaccine or toxoid component administered. When we start talking about Pentacel, it depends on how many components are in there. We got those add-on codes are there for the additional components in there. You’d have to use that add-on code for the additional components included in that vaccine.

Alicia: And the components are listed out. Right?

Chandra: No, that’s… here I was talking about the specific administration codes, the 90460 to the 90474, those are for the administration. For the actual products, you would have a combination product code that said you were giving Pentacel for DTaP. It includes the tetanus, the pertussis, all of that; there is a combination code for that included in the range of 90476 through – wow, this just keeps getting bigger every year, don’t they?

Alicia: Yeah. She found a thing on this, hear this: Quick tips for Pentacel vaccine, so…

Laureen: So, 90698 is the CPT code –

Chandra: Product code.

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