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Use 90460 and 90461 when all of these apply: The patient is through 18 years of age A physician or QHP delivers vaccine counseling at the visit Reporting runs per vaccine component, with 90460 for the first component (work RVU 0.23) and 90461 for each additional component (work RVU 0.18) Use 90471 and 90472 when any of these apply: The patient is any age No counseling is documented for a patient through age 18 Reporting runs per vaccine rather than per component A combination vaccine with multiple antigens generates multiple components under 90460 and 90461

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If the hanging skin causes chafing, consult a plastic surgeon