# 90715



## deut649 (Nov 15, 2010)

my 90715's are getting denied for people over 18..what am i doing wrong.


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## mitchellde (Nov 15, 2010)

what does the denial indicate?  it is probably due to not covered.


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## cmcgarry (Nov 17, 2010)

Most insurances don't cover very many routine vaccinations for adults.  I would check with the payer to see if this is a contract exclusion (in which case you can usually bill the patient).  Each payer has different policies; and even different groups can purchase different benefits.

On a personal note - I had my booster (Tdap) and didn't even expect the insurance to pay for it - but of course, I work for insurance so I should know my own benefits!

If your EOB puts it to patient responsibility, it is probably non-covered and you can bill the patient; if, however, they put it to provider and want you to write it off, I would be calling them.

Hope this helps,


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