Correct coding helps ensure that a practice receives payment for vaccines given to patients. ACOG has published a coding guide solely focused on immunization, Immunization Coding for Obstetrician-Gynecologists 2013, and a quick glance guide for frequently used immunization codes. Proper coding means being sure that the code selected is appropriate as follows:
The code represents the most accurate description of “what” was performed and “why” it was performed consistent with coding conventions and guidelines
The code is supported by documentation in the medical record
The Current Procedural Terminology (CPT) coding guidelines state that the code selected must be the most accurate description of the service provided and be consistent with coding conventions and guidelines. Individuals responsible for coding should carefully review their coding books, including any coding guidelines, notes, instructions, or other explanatory statements. These may be printed under subsections, headings, subheadings, or before and after codes. The physician also should know the bundling and unbundling rules used by CPT, commercial payers, and the Centers for Medicare & Medicaid Services.
ICD-10 Implementation: The Department of Health and Human Services has announced that the International Classification of Diseases, 10th Revision, Clinical Modification (ICD-10-CM), will be implemented in the United States on October 1, 2014. After September 30, 2014, ICD-9-CM codes will no longer be reportable. As additional updates and resources regarding this change become available, they will be posted here.
ACOG Coding Quick Glance Guides: (scroll past physician script to reach coding information)
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Last Updated: 12/3/2013