Coding Cues: Coding for immune globulin injections

Key Points

I sometimes give immune globulin injections to patients traveling outside the US. I use the 90281 (immune globulin) code plus 90471 (immunization administration), in addition to the code for the visit, but the administration is always denied. Can you tell me why?

Code 90281 representing immune globulin is not classified as an immunization. Thus, 90471 should not be used to report administration; instead, use 90772 (therapeutic, prophylactic, or diagnostic injection) when there is direct physician supervision. And some insurers bundle injection administration into the E&M service provided on the same date, so even with the correct code, you may continue to get rejections.