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Pediatric Coding Alert

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Fighting Denials for Male HPV Vaccines? Try These Strategies

Published on Mon Oct 03, 2011

Let staff know about carrier challenges, and prepare a waiver when necessary. Nearly two years ago, the FDA approved the HPV vaccine Gardasil® for male patients, but many pediatric practices continue to struggle for payment when administering the product to boys. Read on to find out how you can avoid losing money if you offer this relatively new vaccine. Background: Gardasil® prevents precancerous genital lesions and genital warts due to the human papilloma virus (HPV) types 6, 11, 16, and 18. Initially approved for female patients, the vaccine was extended to male patients as well in October 2009 thanks to an FDA approval announcement. However, despite the FDA's stamp of approval, several insurers are still slow to pay for this vaccine when administered to male patients. Follow these steps to ensure you collect for the vaccines: 1. Check insurer coverage. It may be time-consuming up-front, but you'll save your energy [...]
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