Pediatric Coding Alert
No 'Wrong Dosage' Modifier Exists
Question: Which codes apply if we administer the wrong dosage of medication to a patient? We erroneously administered the adult dosage of a Hepatitis B vaccine to a pediatric patient. Is it okay to bill the child CPT code for Hepatitis B with a modifier indicating that we administered the wrong dosage?
Answer: Unfortunately, no such modifier exists. Because CPT regulations dictate that you have to bill for the services you actually performed, you must report the adult code (90739) in this case rather than the pediatric dosage (90744) or adolescent dosage (90743).
The insurer could end up denying the charge based on the patient’s age, but it’s not appropriate to administer the adult dosage and bill for the pediatric one, because if your charts are ever audited, the payer could notice the discrepancy and determine that you got paid for a service you did not perform.
Pediatric Coding Alert
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No 'Wrong Dosage' Modifier Exists
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