{"id":16432,"date":"2021-09-13T17:48:28","date_gmt":"2021-09-13T17:48:28","guid":{"rendered":"https:\/\/websites.awesomified.com\/doctorcare\/?p=16432"},"modified":"2021-09-14T15:37:50","modified_gmt":"2021-09-14T15:37:50","slug":"msp-billing-how-to-bill-for-immunizations-and-injections","status":"publish","type":"post","link":"https:\/\/websites.awesomified.com\/doctorcare\/msp-billing-how-to-bill-for-immunizations-and-injections\/","title":{"rendered":"MSP Billing: How to Bill for Immunizations and Injections"},"content":{"rendered":"\n<p>In British Columbia, billing immunizations and injections can be quite complicated as there are different requirements for patients depending on their age. We are finding that many physicians are billing these codes incorrectly and are spending a lot of time fixing errors or missing out on revenue potential. In this blog, we will share a breakdown of the latest updates to immunization and injection codes and provide examples to help you reduce billing errors and rejections.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\">MSP Billing Codes for Patients 18 Years of Age and Younger<\/h2>\n\n\n\n<h4 class=\"wp-block-heading\"><strong>Infants and Children Immunizations<\/strong><\/h4>\n\n\n\n<p>The following chart outlines the timing and billing codes for immunizations and injections for children in British Columbia between the ages 0 and 4 years. All fee codes are valued at $5.43.<\/p>\n\n\n\n<figure class=\"wp-block-table\"><table><tbody><tr><td>Fee Code<\/td><td>Vaccine<\/td><td>2 Months<\/td><td>4 Months<\/td><td>6 Months<\/td><td>12 Months<\/td><td>18 Months<\/td><td>Starting at 4 years<\/td><\/tr><tr><td>10027<\/td><td>DTap-HB-IPV-Hib<\/td><td>X<\/td><td>X<\/td><td>X<\/td><td>&nbsp;<\/td><td>&nbsp;<\/td><td>&nbsp;<\/td><\/tr><tr><td>10023<\/td><td>Pneumococcal Conjugate<\/td><td>X &nbsp;<\/td><td>X<\/td><td>&nbsp;<\/td><td>X<\/td><td>&nbsp;<\/td><td>&nbsp;<\/td><\/tr><tr><td>10029<\/td><td>Rotavirus<\/td><td>X<\/td><td>X<\/td><td>&nbsp;<\/td><td>&nbsp;<\/td><td>&nbsp;<\/td><td>&nbsp;<\/td><\/tr><tr><td>10020<\/td><td>Meningococcal C Conjugate<\/td><td>X<\/td><td>&nbsp;<\/td><td>&nbsp;<\/td><td>X<\/td><td>&nbsp;<\/td><td>&nbsp;<\/td><\/tr><tr><td>10022<\/td><td>MMR<\/td><td>&nbsp;<\/td><td>&nbsp;<\/td><td>&nbsp;<\/td><td>X<\/td><td>&nbsp;<\/td><td>&nbsp;<\/td><\/tr><tr><td>10026<\/td><td>Varicella<\/td><td>&nbsp;<\/td><td>&nbsp;<\/td><td>&nbsp;<\/td><td>X<\/td><td>&nbsp;<\/td><td>&nbsp;<\/td><\/tr><tr><td>10027<\/td><td>DTaP-IPV-Hib<\/td><td>&nbsp;<\/td><td>&nbsp;<\/td><td>&nbsp;<\/td><td>&nbsp;<\/td><td>X<\/td><td>&nbsp;<\/td><\/tr><tr><td>10010<\/td><td>Tdap-IPV<\/td><td>&nbsp;<\/td><td>&nbsp;<\/td><td>&nbsp;<\/td><td>&nbsp;<\/td><td>&nbsp;<\/td><td>X<\/td><\/tr><tr><td>10030<\/td><td>MMRV<\/td><td>&nbsp;<\/td><td>&nbsp;<\/td><td>&nbsp;<\/td><td>&nbsp;<\/td><td>&nbsp;<\/td><td>X<\/td><\/tr><tr><td>10015<\/td><td>Influenza<\/td><td>&nbsp;<\/td><td>&nbsp;<\/td><td>X<\/td><td>X<\/td><td>X<\/td><td>X<\/td><\/tr><tr><td>10016<\/td><td>Hepatitis A<\/td><td>&nbsp;<\/td><td>&nbsp;<\/td><td>X<\/td><td>&nbsp;<\/td><td>X<\/td><td>&nbsp;<\/td><\/tr><\/tbody><\/table><\/figure>\n\n\n\n<p>Billing Requirements<\/p>\n\n\n\n<ul class=\"wp-block-list\"><li>Billable in addition to an office visit<\/li><li>Bill the vaccine code with the ICD-9 code 33A<\/li><li>Billable up to 4 vaccinations per patient per day in addition to the office visit<\/li><\/ul>\n\n\n\n<p><\/p>\n\n\n\n<p>Let\u2019s look at an example:<\/p>\n\n\n\n<p>A 6-month-old baby girl visits your office for her vaccinations. What should you billing? You should bill the code 12100 for the office visit in addition to the immunization codes she is getting. The chart below breaks it down: <\/p>\n\n\n\n<figure class=\"wp-block-table\"><table><tbody><tr><td>Fee Code<\/td><td>Value<\/td><\/tr><tr><td>12100 Office Visit <br>10027 DTap-H8-IPV-Hib <br>10015 Influenza <br>10016 Hepatitis A<\/td><td>$34.79 <br>$5.43 <br>$5.43 <br>$5.43<\/td><\/tr><tr><td><strong>Total<\/strong><\/td><td><strong>$51.08<\/strong><\/td><\/tr><\/tbody><\/table><\/figure>\n\n\n\n<h4 class=\"wp-block-heading\"><strong>School Age Immunizations<\/strong><\/h4>\n\n\n\n<p>The following chart lists all vaccines that are provided to children in British Columbia who are in grades 6 and 9. All fee codes are valued at $5.43.<\/p>\n\n\n\n<figure class=\"wp-block-table\"><table><tbody><tr><td>Fee Code<\/td><td>Vaccine<\/td><td>Grade 6<\/td><td>Grade 9<\/td><\/tr><tr><td>10017<\/td><td>Hepatitis B<\/td><td>2 doses<\/td><td>&nbsp;<\/td><\/tr><tr><td>10028<\/td><td>HPV<\/td><td>2 doses<\/td><td>&nbsp;<\/td><\/tr><tr><td>10026<\/td><td>Varicella<\/td><td>1 or 2 doses<\/td><td>&nbsp;<\/td><\/tr><tr><td>10021<\/td><td>Meningococcal Quadrivalent Conjugate<\/td><td>&nbsp;<\/td><td>1 dose &nbsp;<\/td><\/tr><tr><td>10014<\/td><td>Tdap<\/td><td>&nbsp;<\/td><td>1 dose<\/td><\/tr><\/tbody><\/table><\/figure>\n\n\n\n<p>Billing Requirements<\/p>\n\n\n\n<ul class=\"wp-block-list\"><li>Billable in addition to an office visit<\/li><li>Bill the vaccine code with ICD-9 code 33A<\/li><li>Up to 4 vaccinations are billable per patient per day in addition to the office visit<\/li><\/ul>\n\n\n\n<p><\/p>\n\n\n\n<p>Here is an example:<\/p>\n\n\n\n<p>A boy in grade 9 comes into your office for their vaccinations. As with the children and infants immunizations, you should bill the code for the office visit (in this case, 00100) in addition to the codes for the immunizations he is getting. The chart below breaks it down:<\/p>\n\n\n\n<figure class=\"wp-block-table\"><table><tbody><tr><td>Fee Code<\/td><td>Value<\/td><\/tr><tr><td>00100 Office Visit <br>10021 Meningococcal Quadrivalent Conjugate <br>10014 Tdap<\/td><td>$31.62 <br>$5.43 &nbsp; <br>$5.43<\/td><\/tr><tr><td><strong>Total<\/strong><\/td><td><strong>$42.48<\/strong><\/td><\/tr><\/tbody><\/table><\/figure>\n\n\n\n<h2 class=\"wp-block-heading\">MSP Billing Codes for Immunizations for Patients 19 Years of Age and Older<\/h2>\n\n\n\n<p><meta charset=\"utf-8\">The following chart lists all vaccines available to patients 19 years of age or older who were not immunized in childhood. It also lists the recommended vaccines for those who are in high-risk groups, such as those with chronic illness or weakened immune systems. <\/p>\n\n\n\n<figure class=\"wp-block-table\"><table><tbody><tr><td>Vaccine<\/td><td>1<sup>st<\/sup> visit<\/td><td>4 weeks later<\/td><td>2 months after 1<sup>st<\/sup> visit<\/td><td>6 months after 1<sup>st<\/sup> visit<\/td><td>6 months after 2<sup>nd<\/sup> visit<\/td><td>Every 10 years<\/td><\/tr><tr><td>Meningococcal C Conjugate<\/td><td>X<\/td><td>&nbsp;<\/td><td>&nbsp;<\/td><td>&nbsp;<\/td><td>&nbsp;<\/td><td>&nbsp;<\/td><\/tr><tr><td>Meningococcal Quadrivalent Conjugate<\/td><td>X<\/td><td>&nbsp;<\/td><td>&nbsp;<\/td><td>&nbsp;<\/td><td>&nbsp;<\/td><td>&nbsp;<\/td><\/tr><tr><td>Tdap<\/td><td>X<\/td><td>&nbsp;<\/td><td>&nbsp;<\/td><td>&nbsp;<\/td><td>&nbsp;<\/td><td>&nbsp;<\/td><\/tr><tr><td>MMR<\/td><td>X<\/td><td>X<\/td><td>&nbsp;<\/td><td><\/td><td>&nbsp;<\/td><td>&nbsp;<\/td><\/tr><tr><td>Hepatitis B<\/td><td>X<\/td><td>X<\/td><td>&nbsp;<\/td><td>X<\/td><td>\u00a0<\/td><td>&nbsp;<\/td><\/tr><tr><td>HPV<\/td><td>X<\/td><td>&nbsp;<\/td><td>X<\/td><td>X<\/td><td>&nbsp;<\/td><td>&nbsp;<\/td><\/tr><tr><td>Varicella<\/td><td>X<\/td><td>&nbsp;<\/td><td>X<\/td><td>&nbsp;<\/td><td>&nbsp;<\/td><td>&nbsp;<\/td><\/tr><tr><td>Td<\/td><td>&nbsp;<\/td><td>X<\/td><td>&nbsp;<\/td><td>&nbsp;<\/td><td>X<\/td><td>X<\/td><\/tr><tr><td>Influenza<\/td><td>X<\/td><td>X<\/td><td>X<\/td><td>X<\/td><td>X<\/td><td>X<\/td><\/tr><tr><td>Pneumococcal Polysaccharide<\/td><td>X<\/td><td>X<\/td><td>X<\/td><td>X<\/td><td>X<\/td><td>X<\/td><\/tr><\/tbody><\/table><\/figure>\n\n\n\n<p>For these patients &nbsp;there are two codes that you can use to bill for immunizations and injections. For intramuscular injections use fee code 00010 and for subcutaneous injections use fee code 00034. Please note that you will only bill these codes If the sole purpose of the visit is the injection.<\/p>\n\n\n\n<figure class=\"wp-block-table\"><table><tbody><tr><td>Fee Code<\/td><td>Description<\/td><td>Value<\/td><\/tr><tr><td>00010<\/td><td>Injection, Intramuscular &nbsp; Intramuscular (IM) injection includes influenza (flu) shot and other IM immunizations for patients 19 years or older<\/td><td>$11.37<\/td><\/tr><tr><td>00034<\/td><td>Injection, subcutaneous &nbsp; Subcutaneous injections including desensitization treatments, immunization, oral polio vaccine, etc. (maximum charge per sitting \u2013 3)<\/td><td>$11.37<\/td><\/tr><\/tbody><\/table><\/figure>\n\n\n\n<p>Billing Requirements<\/p>\n\n\n\n<ul class=\"wp-block-list\"><li>Codes apply to all MSP funded vaccinations as well as other injections such as vitamin B12 testosterone and allergy shots<\/li><li>Bill the vaccine code with ICD-9 code 33A<\/li><li>A maximum of three of any combination of 00010 and 00034 are billable per patient per day<\/li><li>Fee code 00010 and 00034 are not billable with a visit fee for the same patient on the same day<\/li><\/ul>\n\n\n\n<p><\/p>\n\n\n\n<p>Here is an example:<\/p>\n\n\n\n<p>A 40-year-old man comes in to get his allergy<a> <\/a>shot. How much would you bill?<\/p>\n\n\n\n<figure class=\"wp-block-table\"><table><tbody><tr><td>Fee Code<\/td><td>Value<\/td><\/tr><tr><td>00010 Injection, Intramuscular<\/td><td>$11.37<\/td><\/tr><tr><td>Total<\/td><td>$11.37<\/td><\/tr><\/tbody><\/table><\/figure>\n\n\n\n<p>In this example, you only bill the 00010 fee code for $11.37 because the sole purpose of the man\u2019s visit was to get his allergy shot. In the case where he may have come in for another reason and decided to get the shot as well, you would only bill for the office visit (fee code 00100).<\/p>\n\n\n\n<h2 class=\"wp-block-heading\">Temporary MSP Billing Fee Codes for Immunization<\/h2>\n\n\n\n<p>During the COVID-19 pandemic, the Ministry added the following four temporary fee codes to incentivize respiratory vaccines.<\/p>\n\n\n\n<figure class=\"wp-block-table\"><table><tbody><tr><td>Fee Codes<\/td><td>Description<\/td><td>Value<\/td><\/tr><tr><td>T10042<\/td><td>COVID-19 immunization (with visit)<\/td><td>$5.43<\/td><\/tr><tr><td>TB10043<\/td><td>COVID-19 immunization (without visit)<\/td><td>$14<\/td><\/tr><tr><td>TB10044<\/td><td>Extended COVID-19 Immunization (extra)<\/td><td>$17.62<\/td><\/tr><tr><td>T10045<\/td><td>COVID-19 immunization advice fee (extra)<\/td><td>$17.62<\/td><\/tr><\/tbody><\/table><\/figure>\n\n\n\n<p>Please note that all COVID-19 fee codes are required to be billed with the diagnostic code C19.<\/p>\n\n\n\n<p>For more information on how to bill COVID-19 immunization codes, read our blog on <a href=\"https:\/\/websites.awesomified.com\/doctorcare\/understanding-msp-billing-codes-for-covid-19-virtual-care-and-telehealth\/\" target=\"_blank\" rel=\"noreferrer noopener\">Understanding MSP Billing Codes for COVID-19, Virtual Care and Telehealth here<\/a>.<\/p>\n\n\n\n<p>Have questions on how to bill the MSP billing codes for immunizations and injections? Contact us today! We\u2019re happy to help.<\/p>\n\n\n\n<div class=\"wp-block-buttons is-layout-flex wp-block-buttons-is-layout-flex\">\n<div class=\"wp-block-button\"><a class=\"wp-block-button__link\" href=\"https:\/\/websites.awesomified.com\/doctorcare\/contact\/\">Contact Us<\/a><\/div>\n<\/div>\n\n\n\n<p><\/p>\n","protected":false},"excerpt":{"rendered":"<p>In British Columbia, billing immunizations and injections can be quite complicated as there are different requirements for patients depending on their age. We are finding that many physicians are billing these codes incorrectly and are spending a lot of time fixing errors or missing out on revenue potential. In this blog, we will share a [&hellip;]<\/p>\n","protected":false},"author":11,"featured_media":16433,"comment_status":"closed","ping_status":"","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[105],"tags":[126,133],"location":[],"class_list":["post-16432","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-blog","tag-bc-billing-codes","tag-british-columbia"],"_links":{"self":[{"href":"https:\/\/websites.awesomified.com\/doctorcare\/wp-json\/wp\/v2\/posts\/16432","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/websites.awesomified.com\/doctorcare\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/websites.awesomified.com\/doctorcare\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/websites.awesomified.com\/doctorcare\/wp-json\/wp\/v2\/users\/11"}],"replies":[{"embeddable":true,"href":"https:\/\/websites.awesomified.com\/doctorcare\/wp-json\/wp\/v2\/comments?post=16432"}],"version-history":[{"count":11,"href":"https:\/\/websites.awesomified.com\/doctorcare\/wp-json\/wp\/v2\/posts\/16432\/revisions"}],"predecessor-version":[{"id":16458,"href":"https:\/\/websites.awesomified.com\/doctorcare\/wp-json\/wp\/v2\/posts\/16432\/revisions\/16458"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/websites.awesomified.com\/doctorcare\/wp-json\/wp\/v2\/media\/16433"}],"wp:attachment":[{"href":"https:\/\/websites.awesomified.com\/doctorcare\/wp-json\/wp\/v2\/media?parent=16432"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/websites.awesomified.com\/doctorcare\/wp-json\/wp\/v2\/categories?post=16432"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/websites.awesomified.com\/doctorcare\/wp-json\/wp\/v2\/tags?post=16432"},{"taxonomy":"location","embeddable":true,"href":"https:\/\/websites.awesomified.com\/doctorcare\/wp-json\/wp\/v2\/location?post=16432"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}