Tetanus and Diphtheria toxoids (90702, 90714, 90718) - These injections are temporarily being covered when given for an acute injury to a person who is incompletely immunized. This is due to the limited availability of the Tetanus toxoid. ICD-9 codes: V03.7, 870.0-897.7, 910.0-919.9 When the availability of tetanus toxoid increases we may rescind coverage of these codes.
90714 Tetanus and diphtheria toxoids (Td) adsorbed, preservative free, for use in individuals seven years or older, for intramuscular use
NOTE: Code 90714 is currently effective for Medicare 01/01/2006. For prior dates of service, use code 90718 to report these services.
Diphtheria, antitoxin (CPT 90296) will be covered for the treatment of diphtheria. The following ICD-9 codes will be allowed: 032.0-032.3, 032.81-032.85, 032.89, 032.9.
UPDATE ON CPT® CODE 90714
The American Medical Association (AMA) has issued CPT® code 90714 to identify preservative-free Tetanus and Diptheria Toxoids Adsorbed for Adult Use (Td vaccine).
The AMA CPT Committee posted CPT 90714 on their Web site on January 1, 2005 with an effective date of July 1, 2005. The AMA CPT Committee is advising the use of CPT 90749, Unlisted Vaccines, prior to July 1, 2005.
The Advisory Committee on Immunization (ACIP) recommends the use of the Td vaccine for:
• Persons 7 years of age or older who have not been immunized previously against tetanus and diphtheria as a primary immunization series of three 0.5 mL doses1
• Use as a routine booster every 10 years throughout life for persons 7 years of age or older who have received a primary series of tetanus and diphtheriacontaining vaccine1
• Wound care in persons who have not received a tetanus-toxoid-containing preparation within the preceding five years If you have any questions about this update please contact your Network Management Representative or Provider Inquiry.
Effective July 1, 2005:
• CPT code 90718 is used for the tetanus and diphtheria toxoids (Td) vaccine absorbed for use in an individual seven years or older, for intramuscular use; and
• 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.
Medicaid Billing Instructions
For Vaccines for Children (VFC)-eligible patients, birth through 18 years of age, providers must document the correct CPT code(s) on the CMS 1500 claim form in order to receive reimbursement for the administration of a vaccination(s) given to a VFC-eligible patient from VFC vaccine stock. This applies to Medicaid children only. An office visit or an EPSDT screening visit may be billed in addition to vaccination administration fees.
The vaccination administration fee for American Indian, Alaskan Native, uninsured, and underinsured patients must be collected from the parent or guardian, not Medicaid. The administration fee must be waived if the parent or guardian cannot pay. Underinsured children can only receive VFC vaccine at a Federally Qualified Health Center (FQHC) or Rural Health Center (RHC).
The following CPT codes must be used when billing Medicaid for the $8.00 administration fee (for each immunization administered) to Medicaid children:
90714 Tetanus, Diphtheria (Td), preservative-free