Name of Manual - Blue Cross and Blue Shield of Minnesota

Coding Policies and Guidelines (Medical Services)
Immunizations
(continued)
11-26
Serum from Department of Human Services
If receiving serum from the Department of Human Services (DHS)
for child immunizations, the provider should bill Blue Cross for
the administration charge only. Providers should submit the
immunization code with an –SL modifier to indicate the serum was
received from DHS. Providers are required to obtain serum from
DHS for all PMAP enrollees. The administration codes 90460-
90461, 90471-90474, or G0008-G0010 must be reported in
addition to the vaccine. If the vaccine code is submitted it should
be reported with a zero charge. Blue Cross will allow the line to be
submitted with a $0.01 charge if the provider’s billing systems or
services cannot accommodate a zero charge.
Minnesota Health Care Programs (MHCP) payment for
vaccine administration code 90461
Blue Plus is following the DHS guidelines for payment of vaccine
administration. Based upon these guidelines, only the single or
first vaccine/toxoid component will be reimbursed for Blue Plus
MHCP members. Blue Plus reminds providers that, effective
January 1, 2011, claim lines submitted for MHCP members with
procedure code 90461 are being denied as part of the basic service.
See DHS provider communication below:
MHCP-covered Immunization Administration
(vaccines/toxoids). Use the following codes to report
immunization administration in conjunction with each single or
combination vaccine/toxoid code reported.
Code Use to report
administration of:
90471 First vaccine
(single or
combination)
90472 Each additional
vaccine
Administration
route
Percutaneous,
intradermal,
subcutaneous,
intramuscular
Percutaneous,
intradermal,
subcutaneous,
intramuscular
MHCP
limitations
Do not use with
90473
Use with 90471
or 90473; list
separately
Blue Cross and Blue Shield of Minnesota Provider Policy and Procedure Manual (06/20/12)