Missing out on reporting administration codes when your pulmonologist provides pneumovax vaccines can lead to partial payments for the services rendered. Take control of your pneumovax vaccines reimbursement by following these steps to correct coding.
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If your pulmonologist administers a pneumovax vaccine, ensure that she provides adequate documentation to support the medical necessity of providing the vaccine. Some instances of medical necessity will include age
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over 65 years with respiratory issues like asthma or COPD; patients with other medical conditions like congestive heart failure, cirrhosis, diabetes mellitus; and patients who are immunosuppressed (due to chemotherapy, HIV, after organ transplantation, or currently on immunosuppressive drugs).
The documentation provided should also include details such as the type (manufacturer and lot #) of vaccine that is administered and the route of administration employed by your pulmonologist. The purpose of administration and patient response should also be included in the documentation.
When your pulmonologist administers a pneumococcal conjugate vaccine, you report the vaccine with one of the following codes:
- 90669 (Pneumococcal conjugate vaccine, 7 valent, for intramuscular use)
- 90670 (Pneumococcal conjugate vaccine, 13 valent, for intramuscular use)
- 90732 (Pneumococcal polysaccharide vaccine, 23-valent, adult or immunosuppressed patient dosage, when administered to individuals 2 years or older, for subcutaneous or intramuscular use)
“The CDC (Centers for Disease Control) recommends pneumococcal conjugate vaccine (90669, 90670) for all children less than 59 months old,” says Carol Pohlig, BSN, RN, CPC, ACS, senior coding and education specialist at the University of Pennsylvania, Department...
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