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Iowa Immunizations

Jolene Posted Tue 01st of October, 2013 15:09:13 PM

"What are the requirements for who provides counseling for vaccine administration in Iowa? Is it only a Physician, Physician Assistant or Nurse Practitioner that can give the counseling or can it be given by an RN, Certified Medical Assistant or Medical Assistant? This would be counseling given at the time of the immunization that we want to document and bill to insurance."
Thank you.

SuperCoder Answered Tue 01st of October, 2013 21:40:59 PM

You mention counseling, so are the codes in mind 90460 and +90461? These codes specify “counseling by physician or other qualified health care professional.” RNs and medical assistants are ‘clinical staff’ rather than ‘qualified healthcare professionals’ under the CPT definition:

‘A “physician or other qualified health care professional” is an individual who is qualified by education, training, licensure/regulation (when applicable), and facility privileging (when applicable) who performs a professional service within his or her scope of practice and independently reports that professional services. These professionals are distinct from “clinical staff.” A clinical staff member is a person who works under the supervision of a physician or other qualified health care professional, and who is allowed by law, regulation and facility policy to perform or assist in the performance of a specific professional service, but does not individually report that professional service.’

This site indicates Iowa ARNPs may provide counseling/education to patients (although it isn’t explicitly linked to the vax codes):

Jolene Posted Wed 02nd of October, 2013 12:46:43 PM

Yes I am sorry I did not include the code numbers I was referring to. You again answered my question very well. Thank you very much!

SuperCoder Answered Wed 02nd of October, 2013 17:31:09 PM

You are always welcome!

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