When billing a vaccine with both administration and product codes, what should be submitted?

• A. Submit only the vaccine product code
• B. Submit only the administration code
• C. Submit the vaccine product code along with the corresponding administration code
• D. Submit a CPT modifier to indicate the combination

Answer: (C)

When billing a vaccine, you must capture both parts of the service: the vaccine itself and the act of giving it. The vaccine product code identifies the exact vaccine and dose that was administered, while the administration code (the CPT code) accounts for the clinician’s time and method of delivering the vaccine (for example, the injection route and technique). Reporting both codes ensures the payer reimburses for the vaccine product and the administration service. If multiple vaccines are given in one visit, each vaccine should be reported with its own product code and corresponding administration code. A CPT modifier isn’t used to indicate this combination.