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Pediatric Coding Alert

Reader Questions:

Claim Timing Could Keep Away 90670 Pay

Published on Thu May 27, 2010

Question:We've had trouble being paid for 90670. What diagnosis should we report, and should we follow certain guidelines?Alabama Subscriber Answer:CPT 2010 added 90670 (Pneumococcal conjugate vaccine, 13 valent, for intramuscular use) with a notation of "FDA approval pending." The code went into effect May 25, 2010, so insurers will reject any claims you submitted before that date. Smaller plans and PPO networks can take longer to recognize new vaccines, so prepare to resubmit with documentation of the code's acceptability. In terms of a diagnosis, report V03.82 (Need for prophylactic vaccination and inoculation against bacterial diseases; Streptococcus pneumoniae [pneumococcus]).
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