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Immunization base and add on codes
We are having our bluecross claims denied when we bill codes 90471 and 90472 with the explanation: This service has been denied because the add on code was submitted without it's corresponding base code. We are billing the code for the immunization (example 90744 for hepB) with 90471. 90471 is being denied. Similarly for multiples immunizations both 90471 and 90472 are being denied. What is wrong?
90471 and 90472
Make sure the child is over 8 years of age in order to use these administration codes, if the child is under 8 you should be using 90465 and 90466, otherwise these codes are payable and I would fight to have them paid
90471 and 90472
Allison Singer, CPC has posted a terrific article called, "Reporting Administration Codes with Vaccines." You can find it on the first page of Codapedia, or by searching any of those words in the search box.
Immunization Administration-Blue Cross
Anthem has noted an incorrect denial issue with 90471 and 90465. They were to have the edit fixed by March 14, 2010. They also said the adjustment request is not needed as they will reprocess all incorrect claims that may have denied incorrectly. We are resubmitting all incorrect denials as I don't trust them to just auto process and pay.