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December 2016 Texas Medicaid Provider Procedures Manual

Children’s Services Handbook : Appendix B. Immunizations : B.3 General Recommendations : B.3.2 Administrations and Immunizations

B.3.2
B.3.2.1
The following administration procedure codes must be submitted in combination with an appropriate vaccine/toxoid procedure code:
 
Procedure codes 90460 and 90461 are benefits for services rendered to clients who are birth through 18 years of age when counseling is provided for the immunization administered. Documentation of counseling by the physician or other qualified health-care professional must be noted in the client’s medical record.
Procedure codes 90471 and 90472 are benefits for services rendered to clients of any age when counseling is not provided for the immunization administered. Procedure codes 90473 and 90474 are benefits for services rendered to clients who are birth through 20 years of age when counseling is not provided for the immunization administered.
Refer to:
Subsection 5.3.11.3, “Immunizations” in this handbook for appropriate diagnosis codes for immunization administration.

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