Pediatric Coding Alert
One Payer Formally Confirms Male HPV Vaccine Payment
United Healthcare now covers these vaccinations for males and females ages nine through 26. You can rest easy when filing your HPV vaccine claims for male patients, at least for one national payer, thanks to a recent policy update by United Healthcare. As we reported in Vol., 14, No. 11 of Pediatric Coding Alert, pediatric practices have been struggling to collect payment for administering the HPV vaccine Gardasil® to male patients. In its February 2012 "Medical Policy Update Bulletin," United Healthcare announced that "coverage of Gardasil for males will be effective February 1, 2012," but that claims will not retroactively be adjusted for any services performed prior to Feb. 1. The UHC coverage is now in effect for both males and females aged nine through 26 years. To read the full UHC announcement, visit www.unitedhealthcareonline.com/ccmcontent/ProviderII/UHC/en-US/Assets/ProviderStaticFiles/ProviderStaticFilesPdf/Tools%20and%20Resources/Policies%20and%20Protocols/Medical%20Policy%20Update%20Bulletins/Policy%20Update%20Bulletins/Medical_Policy_Update_Bulletin_February_2012.pdf.
Pediatric Coding Alert
- Billing Errors:
One Medicaid Payer Reveals Its Top 5 Errors -- Know How You Can Avoid Making the Same Mistakes
Coding errors once again top the list of the most common mistake. Did you catch [...] - Repeat Procedures:
Differentiate Your Distinct and Repeat Procedures With These 6 Quick Tips
Use modifiers 59, 76 and 77, and 91 without jeopardizing your pay. When you consider [...] - ICD-10:
Consider These Epistaxis Changes Under ICD-10
Plus: HHS confirms that ICD-10 date will be pushed back. Although nosebleeds can be common [...] - Clip And Save:
Know These 'Repeat Procedure' Modifiers -- And When You Should Use Them
Keeping your repeat modifiers straight can be confusing--look to this simple chart to help ease [...] - You Be the Coder:
Contraception Diagnosis Code Depends on Specifics
Question: One of our practitioners discussed sexual activity and contraception with an adolescent. Which ICD-9 [...] - News You Can Use:
One Payer Formally Confirms Male HPV Vaccine Payment
United Healthcare now covers these vaccinations for males and females ages nine through 26.You can [...] - Reader Question:
Even 'Quick Assessment' Creates Established Patient Status
Question: Our pediatrician saw a newborn as a quick assessment within a few days of [...]
