Pediatric Coding Alert

Purchased product pay remains the same. If a recent bulletins got you scared that a major insurer will end 90476-90749 coverage, stop worrying. Key: The childhood immunization protocol applies only to Medicaid patients. Your current reimbursement from UnitedHealthcare for immunizations remains unchanged, UHC stressed in a February Nevada Medicaid memo. The release responded to concerns caused by UHCs January 2009 bulletin, which led some coders to think that the insurer is no longer covering immunizations. Practices would have to use VFC product and bill the insurer for the administration using modifier SL (State supplied vaccine). UHC-Run Medicaid Programs Require 2 Codes In some states, a commercial plan, such as UHC or Blue Cross, contracts for the Medicaid plan, explains Christine Newman, office manager at Oyster Bay Pediatrics in New York. Under the UHC Medicaid programs, when a Medicaid patient receives a VFC product, you bill the administration(90465-+90474) with modifier SL [...]