Billing for Preservative Free Diptheria/Tetanus Vaccine (Decavac)
WPS Medicare is aware that the American Medical Association developed a new code (90714), effective July 1, 2005, for preservative-free DT vaccine (Decavac). Code 90714 did not become effective for billable Medicare services until January 1, 2006.
Based on the Medicare effective date, providers should use procedure 90718 (Tetanus and diphtheria toxoids (Td) adsorbed for use in individuals 7 years or older, for intramuscular use) to report preservative-free DT vaccines administered in 2005.
With either of these codes, (90714 or 90718), if the service is for a routine immunization update, the claim need not be submitted to Medicare because the service is non-covered. To obtain a denial for secondary purposes, or if the beneficiary requests a denial, submit the claim and append a GY modifier to the code.
WPS Medicare will update Local Coverage Decision (LCD) ALRG-003, Immunizations, with this information. You may access ALRG-003 at: http://www.wpsmedicare.com/part_b/policy/policy_active.shtml
