In the CPT Medicine section, immunisation administration codes (90460 to 90474) and vaccine or toxoid product codes (90476 to 90749) form two separate ranges. When a clinician administers a single influenza vaccine to an established patient, how are the services reported?
90460-90474 immunisation administration
90476-90749 vaccine/toxoid products- AReport only the vaccine product code, because the administration work is already bundled into that product code.
- BReport only the immunisation administration code, because it already accounts for the vaccine that was supplied.
- CReport the vaccine product code together with an office visit code used in place of the administration code.
- DReport both a vaccine product code and a separate immunisation administration code for the same encounter. Correct
Why A is wrong: Tempting because the product code seems to describe the whole encounter, but CPT lists administration separately, so reporting the product alone omits the billable administration service.
Why B is wrong: Tempting because the administration code captures the clinical act, but it does not identify or pay for the vaccine product itself, so the supply would go unreported.
Why C is wrong: Tempting because a visit is often present, but an evaluation and management code does not substitute for the specific immunisation administration code CPT assigns.
Why D is correct: Correct: CPT requires the product (what was given) and the administration (the act of giving it) to be reported together, one code from each range.