Name of Manual - Blue Cross and Blue Shield of Minnesota

Coding Policies and Guidelines (Coding)
Helpful Coding Tips We recognize the challenges you have in staying up-to-date with
coding changes. Below are some helpful tips to assist with
accurate and effective coding to support correct claim processing
and reimbursement.
Coding Immunizations
and Injections
11-32
Code using current coding books. Order new CPT and HCPCS
manuals every year, as codes are added, deleted and revised
annually. Submitting invalid or deleted codes will result in claim
rejection or denials. Web links to review for possible updates:
http://www.ama-assn.org/ama/pub/category/3884.html
http://www.cms.hhs.gov/HCPCSReleaseCodeSets/
http://www.cms.hhs.gov/MLNProducts/
http://www.health.state.mn.us/auc/guides.htm
It is appropriate when administering an immunization or injection
to bill administration codes (90460-90461, 90471-90474, 96372-
96375, G0008-G0010). Reimbursement for vaccines/toxoids and
immunization administration is currently allowed in addition to
preventive medicine services (99381-99384, 99391-99394, 99401-
99404) and newborn care services (99460-99463).
Immunizations
If only an immunization is administered, bill the CPT code for the
vaccine/toxoid administered and the applicable CPT administration
code (90460-90474).
Example: A 65-year old patient comes to your office just for a flu
vaccine. Bill the vaccine code 90658 and vaccine administration
code 90471.
Immunizations and E/M Visits
E/M codes 99201-99205 and 99212-99215 are eligible for separate
reimbursement when billed on the same date of service as
vaccine/toxoid codes 90476-90749 and the immunization
administration codes 90461-90461.
Example:
A one-year-old established patient has a preventive visit and a
polio vaccine. Bill the appropriate preventive visit CPT code
(i.e., 99392), the polio vaccine (i.e., 90712) and in this case,
the oral administration code (90473).
Blue Cross and Blue Shield of Minnesota Provider Policy and Procedure Manual (07/12/12)