When you post charges for immunizations, there are also a series of codes with multiple units that need to appear for the immunization administration. Partner’s Snap Codes feature can help your practice post those procedures and diagnoses.
Create Immunization Administration Snap Codes
First, your office can create Snap Codes for the way that you post immunizations. You can create Snap Codes that match your billing needs, using names that you will remember and procedures from your practice’s CPT procedure list. You may want to match what appears on your encounter form, or later adjust your encounter form to match your new Snap Codes.
Learn How to Create a Snap Code: You can read a step-by-step procedure for creating a Snap Code.
Here’s an example of an office’s two Snap Codes for the MMR vaccine in the Table Editor (ted).
When a user enters “MMR w/ Counseling”, the checkout program will automatically enters the MMR vaccine procedure code along with the initial administration code and two units of the “additional antigen” code. All procedures will be linked to both the Well Child diagnosis and the MMR administration diagnosis.
When a user enters “MMR w/o Counseling”, they will see the MMR procedure and the non-counseling 90471 administration code.
Need to Learn More About Immunization Administration Codes?: The administration w/ counseling codes changed on January 1st, 2011. You can read more about the new coding guidelines below, and you can get more details and implementation suggestions in PCC’s 2011 Immunization Administration guide.
Train Your Office
After creating Snap Codes for immunizations, you will need to train your billers and any user who posts charges. Remember that you can create any Snap Codes with any name you want, to make it easy for your staff.
Here’s what it looks like to post an immunization Snap Code during checkout:
Although Snap Codes help ensure consistency and proper coding, your checkout staff should always double-check the procedures and diagnoses that appear and compare them to what the provider indicated on the encounter form. After the codes have “snapped” into place, you can still make changes, increase units, or make other adjustments.
More About Posting w/ Snap Codes: You can read a guide to using Snap Codes.
Recommended Immunization Snap Codes
You may use different names in your practice, and your procedures may have different names in your procedure table, but here are some more immunization administration Snap Code examples:
|Snap Code Name (suggested)||Procedures||Units||Linked Diagnoses|
|DTaP w/ Counseling||90700||1||V20.2 and/or V06.1|
|90460||1||V20.2 and/or V06.1|
|90461||2||V20.2 and/or V06.1|
|DTaP w/o Counseling||90700||1||V20.2 and/or V06.1|
V20.2 and/or V06.1
|Pentacel w/ Counseling||90698||1||V20.2 and/or V06.8|
|90460||1||V20.2 and/or V06.8|
|90461||4||V20.2 and/or V06.8|
|Pentacel w/o Counseling||90698||1||V20.2 and/or V06.8|
|90471||1||V20.2 and/or V06.8|
|Varicella w/ Counseling||90716||1||V20.2 and/or V05.4|
|90460||1||V20.2 and/or V05.4|
|Varicella w/o Counseling||90716||1||V20.2 and/or V05.4|
|90471||1||V20.2 and/or V05.4|
As you can see, each immunization can have both a “with counseling” and “without counseling” version. You can create Snap Codes that will pop in the correct codes for those situations. Whether you link the procedures to the Well Child procedure (V20.2) and/or another procedure is a choice for your office and may depend on billing needs.
Counseling Code Rule: When immunization counseling occurs by a qualified medical professional, you can bill the vaccine’s procedure code, a 90460 for administering the shot’s first antigen, and a 90461 for each additional antigen in the vaccine.
No-Counseling Code Rule: When no counseling occurs, you can bill a 90471 for administration. If you administer several shots, then each subsequent shot would receive one unit of 90472, and the user who posts charges would need to alter the total units.
You should train these rules to any user at your practice who posts immunization charges. Even with the Snap Codes in place, users should review the result before finishing checkout, and they may need to add up and alter administration codes for non-counseling administration.