tci Outpatient Facility Coding Alert - 2015 Issue 2

Reader Question: Know Your Payer to Choose the Vaccine Code

Question: Our facility will be given shingles and the new pneumonia vaccines, Does Medicare pay for the same and if it does what is the appropriate code to use? Texas Subscriber Answer: There are three codes for pneumonia vaccination: 90669 (Pneumococcal conjugate vaccine, 7 valent, for intramuscular use). 90670 (Pneumococcal conjugate vaccine, 13 valent, for intramuscular use). 90732 (Pneumococcal polysaccharide vaccine, 23- valent, adult or immunosuppressed patient dosage, when administered to individuals 2 years or older, for subcutaneous or intramuscular use). Your insurer decides the code: The code you report for the administration of the vaccine will depend upon...

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