Question

Instructions: Review the results generated by CAC software. Compare documentation in the case to the list of possible diagnosis, procedure, and service codes generated by CAC software. Select codes that are supported by documentation in the case (from the list of possible codes generated by CAC software).

Case: Two-year-old established female patient experienced adverse effect to DTAP vaccine, in the form of a skin rash. This occurred 15 minutes after administration of intramuscular DTAP vaccine during encounter for routine child health examination. The well baby evaluation and management service resulted in no abnormal findings.

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Which CPT code is reported for the first-listed procedure?

a. 90714

b. 90471

c. 96372

d. 99392

e. 90472

f. 90749

g. 90460

h. 90461

i. 90702

Answer 1

Ideal code seems to be 90700

Diphtheria, tetanus toxoids, and acellular pertussis vaccine (DTaP), when administered to <7 years, for IM use. This is not among the options. If you are forced to take an option then remember schedule of dtap is 2,4,6and 18 months.n since child is 2 years old assume it as a follow up vaccine . Hence chose 90472

CPT 90714 is used for the tetanus and diphtheria toxoids (Tg) vaccine absorbed, preservative free, for use in individuals seven years or older, for intramuscular use.

Code 90471 is used when the drug is administrated by a medical assistant or nurse and the patient does not see the physician at all. This code would also be used for any patient 19 years of age or older regardless if physician is present and does face-to-face counseling.

CPT® 96372, Under Therapeutic, Prophylactic, and Diagnostic Injections and Infusions (Excludes Chemotherapy and Other Highly Complex Drug or Highly Complex Biologic Agent Administration

CPT® 96372, Under Therapeutic, Prophylactic, and Diagnostic Injections and Infusions (Excludes Chemotherapy and Other Highly Complex Drug or Highly Complex Biologic Agent Administration

90472 (including percutaneous, subcutaneous, intradermal, or intramuscular injections); each
additional vaccine

90749 unlisted vaccine or toxoid

Code 90460 is reported once for the first component of each vaccine or toxoid administered by any route. Used only when physician is present

90461 Through 18 years via any route, with counseling by physician or other qualified health care professional; each additional vaccine/toxoid component.