2011 Vaccine Administration: Now Counseling May Be Given By RNS or LPNS

This year's vaccine administration with counseling extend to any qualified health care professional

This year there are a lot of changes to flu vaccines and counseling codes. From January 1 this year, immunization codes 90465-90468 went off the air; they have been replaced by 90460 and add-on code 90461.

Busy practices were thrilled at being able to use their registered nurses (RN) or licensed practicing nurses (LPN) to capture the higher relative value units (RVUs) some private payers associate with the vaccine administration with counseling codes.

Prior to this, CPT vaccine administration with counseling codes 90465-90468 limited the counselor role to a physician and subject to state scope of practice laws, nurse practitioner (NP) or physician assistant (PA). However, this year's vaccine administration with counseling code extend the counseling opportunity to any qualified health care professional practicing within his/her state described scope of practice.

A registered nurse or licensed practitioner nurse or medical technician could provide the counseling and the practice could still use the vaccine administration with counseling.

On a concluding note: This year's administration codes (90460 and 90461) are per vaccine/toxoid component, meaning if your physician provides counseling and administering for a combination vaccine such as MMR, you will use 90460 for the first component and 90461 for each additional component. In the MMR instance, you would report 90460 once and 90461 twice. Before this year, you'd report only a single vaccine administration code for a combination vaccine irrespective of the number of components in the vaccine.

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