Pediatric Coding Alert

Reader Question:

New Vaccine Code

Question: We just received information regarding a new vaccine product code, CPT 90723 , for diphtheria, tetanus toxoids, acellular pertussis vaccine, hepatitis B, and poliovirus all in one. Will this new code be in the CPT 2001, and when will it be available for use?

Florida Subscriber

Answer: Yes, the American Medical Association (AMA) proactively released the new code for CPT 2001 earlier this year. But the vaccine itself is still in the early stages, so you may not actually be able to use it until later in 2001. The rationale for assigning a code before a product is ready is that once the vaccine is released, then the code will be there so physicians can bill for it and be reimbursed.

The down side of releasing a code like this early, of course, is that some insurance companies will start bundling all of those vaccines together. Currently, the vaccine combination that 90723 will represent is given in three separate injections DtaP, Hepatitis B and poliovirus.