# TDaP was given to 8 year old. Is it billable?



## ed (Mar 7, 2013)

90700 is for DTap, 7 y/o and younger. 
For older than 7 y/o, I found 90715, but it is for Tdap.  When DTaP was giving to 8 year old patient, what code do I use?


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## airart (Mar 14, 2013)

*Older children and Adults - Tdap for age 8 90715*

Found this on the CDC Website:

Older children and adults

*DTaP is not licensed for adolescents, adults, or children 7 years of age and older.*But older people still need protection. A vaccine called Tdap is similar to DTaP. A single dose of Tdap is recommended for people 11 through 64 years of age. Another vaccine, called Td, protects against tetanus and diphtheria, but not pertussis. It is recommended every 10 years. There are separate Vaccine Information Statements for these vaccines.

Per Aetna Website:

In January, 2011, the American Academy of Pediatrics Committee on Infectious Diseases and the ACIP provided the following recommendations for the *use of Tdap va*ccine in children and adults:
•	Removal of a minimum interval between receipt of a tetanus or diphtheria  toxoid containing vaccine and Tdap when Tdap is otherwise indicated.
•	*Administration of a single dose of Tdap to children 7 through 10 years of age with incomplete or unknown pertussis vaccine history.*
•	Administration of a single dose of Tdap to individuals 65 years of age or older who have or anticipate having close contact with an infant younger than 12 months of age (e.g., grandparents, child care providers, health care workers).
•	Administration of a single dose of Tdap in place of Td to any individual 65 years of age or older who has not previously received Tdap.

For an unimmunized person aged 7 years or older (meaning has never had any prior injections since birth and this would be there first), ACIP recommends that tetanus and adult-strength diphtheria toxoids (Td) be administered with a subsequent dose 1-2 months later and a third dose 6-12 months after the second dose. 

•	Secondary prevention of tetanus is accomplished after an acute injury through appropriate wound cleansing and debridement and the administration of Td and human tetanus immune globulin (TIG), when indicated.   ACIP recommends that Td or DPT be administered intramuscularly to patients with tetanus-prone wounds (i.e., those older than 6 hours, deep (greater than 1 cm), grossly contaminated, exposed to saliva or feces, stellate, ischemic or infected (including abscesses), as well as avulsions, punctures, or crush injuries) if they are younger than 7 years and if it has been more than 5 years since their last dose of tetanus.   ACIP also recommends that TIG be administered if patients previously have received fewer than 3 doses of tetanus toxoid and for patients aged 60 years or older. In adults without tetanus-prone wounds, ACIP recommends that Td be administered to patients who previously have received fewer than 3 doses of tetanus toxoid or if it has been more than 10 years since their last dose.
•	DECAVAC (Sanofi Pasteur, Inc.) is a preservative free formulation of tetanus and diphtheria toxoids (Td).  It has been approved by the U.S. Food and Drug Administration (FDA) for active immunization of persons 7 years of age or older for prevention of tetanus and diphtheria.  DECAVAC is supplied as preservative-free prefilled syringes, and according to the manufacturer, contains only trace amounts of thimerosal (mercury derivative) from the manufacturing process. 
•	Boostrix (Tdap) (GlaxoSmithKline) is a combination tetanus toxoid (T), reduced diphtheria toxoid (d) and acellular pertussis vaccine (ap), and has been approved by the FDA as a booster immunization against pertussis in combination with tetanus and diphtheria for individuals 10 through 64 years of age.   Pertussis is generally less severe in adolescents than in infants, but it is thought that adolescents might transmit the disease to susceptible infants and other family members (FDA, 2005).  In the last 20 years, rates of pertussis infection have been increasing in very young infants who have not received all their immunizations and in adolescents and adults (FDA, 2005).  Boostrix has the same components as DTaP vaccine for infants and young children, but in reduced quantities. Boostrix is indicated for use as a single booster dose to adolescents 10 to 18 years of age.  Clinical studies submitted for FDA approval demonstrated that the immune response to the pertussis component of Boostrix in adolescents was adequate compared to the immune response to three doses of DTaP vaccine in infants in a previous study.  The immune response to the T and d components of Boostrix was found to be comparable to standard Td vaccine.  The durability of the immune response to Boostrix is not known.
•	AdacelTM (Tdap) (Sanofi Pasteur, Inc.), is a combination tetanus toxoid (T), reduced diphtheria toxoid (d) and acellular pertussis vaccine (ap), and has been approved by the FDA as a booster immunization against pertussis in combination with tetanus and diphtheria as a single dose in persons 11 through 64 years of age.  Adacel contains the same components as DAPTACEL, a DTaP vaccine indicated for infants and children manufactured by Sanofi Pasteur; however, the diphtheria toxoid and one of the pertussis components are in reduced quantities.  Clinical studies submitted for FDA approval compared the antibody responses of adolescents and adults who received it with the antibody responses of infants who had received Daptacel.  The antibody responses of the adolescents and adults who received a single dose of Adacel were at least as good as those observed in the infants following three doses of Daptacel.  For diphtheria and tetanus, the antibody responses following Adacel were comparable to those following immunization with a U.S. licensed Td vaccine.


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## ed (Mar 16, 2013)

Hi Airart, 
Thank you for replying to my  question!! The information from CDC website explains why there is no CPT for DTaP 7 years and older. 
Thanks agein.


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