How do you ensure immunization coding and billing are accurate?

• A. Use only vaccine procurement codes.
• B. Use vaccine administration codes (CPT 90471-90474) for administration and vaccine product codes for the vaccine itself; verify payer requirements.
• C. Do not bill for immunizations.
• D. Use only ICD-10-CM codes for immunizations.

Answer: (B)

Accurate immunization coding requires listing both the administration and the vaccine product, and checking payer requirements. The administration codes CPT 90471-90474 specifically describe the act of giving the vaccine, reflecting the service provided during the injection. The vaccine product code identifies exactly which vaccine was administered, capturing the item that was given. Billing these on separate lines allows the claim to show both the service performed and the specific product used, which many payers require for proper reimbursement and clear audit trails. Always verify each payer’s rules, because some may have unique requirements such as using NDCs or specific product codes, or may bundle one line item differently. ICD-10-CM codes, by contrast, document the diagnosis or reason for the visit and support the claim but do not replace the need for vaccine administration and product codes.