Don't have a TCI SuperCoder account yet? Become a Member >>

Regular Price: $24.95

Ask An Expert Starting at $24.95
Have a medical coding or compliance question? Don’t sacrifice your valuable time to endless research. Choose Ask an Expert to get clear answers from the TCI SuperCoder team. And here’s a tip for the budget-conscious: Select the 12-question pack to get the best rate per question!

Browse Past Questions By Specialty

+View all

90460s denied as needing a modifiers

Terry Posted Tue 31st of March, 2015 14:56:28 PM

I billed the following claim to an insurance carrier:
99391-25 paid
90648 paid
90460 paid
90700 paid
90460 paid
90685 paid
90460 denied
90670 paid
90460 denied
90680 paid
90460 denied
When I called the representative said that modifiers were needed for the denied charges.

SuperCoder Answered Wed 01st of April, 2015 01:09:57 AM

CPT code 90460 represets Immunization administration through 18 years of age via any route of administration, with counseling by physician or other qualified health care professional; first or only component of each vaccine or toxoid administered. And CPT code 90461 represents Immunization administration through 18 years of age via any route of administration, with counseling by physician or other qualified health care professional; each additional vaccine or toxoid component administered (List separately in addition to code for primary procedure). In your case, You have been paid 2 unit of CPT code 90460. Now bill CPT code 90461 for each additional vaccine/toxoid component. Bill CPT code 90461 with 3 units.

Related Topics