Pediatric Coding Alert

Get ready to change your thinking about Prevnar, because the FDA has approved the Prevnar 13 vaccine for pneumococcal infections. Prevnar 13 (PCV13) replaces Prevnar 7 (PCV7).

Prevnar 13 adds protection against six more strains of the pneumoccocal bacteria, according to The New York Times. The 13 valent vaccine has improved coverage for pediatric pneumococcal infections, including otitis media (382.x, Suppurative and unspecified otitis media).

Keep these key points in mind as you begin offering Prevnar 13:

• The correct CPT code is 90670 (Pneumococcal conjugate vaccine, 13 valent, for intramuscular use).
• The corresponding V code is V03.82 (Other specified vaccinations against single bacterial diseases; streptococcus pneumoniae [pneumococcus]).
• With implementation underway, start contacting your payers about recognition and appropriate payment. It's a tedious task, but important for every group.
• As with the older vaccine, Prevnar 13 is given by intramuscular injections at 2 months, 4 months, 6 months, and between 12 and 15 months of age.
• An immunization advisory committee for the Centers for Disease Control and Prevention recommended that all children less than 5 years of age who received the Prevnar 7 vaccine should get a supplemental dose of Prevnar 13 the next time they visit the doctor, up to 59 months of age.