Primary Care Coding Alert

Question: I read that the CPT 2008 manual doesn't contain three new vaccine codes. Would you explain this, and tell me which codes I shouldn't overlook?

Illinois Subscriber

Answer: Sometimes the AMA accepts a vaccine code, but the approval comes after the publication deadline. Therefore, the vaccine codes aren't printed in the most recently released book. To allow immediate use of the vaccines with a specific code, the AMA releases the codes online and makes them useable.

Because the codes aren't in the CPT 2008 manual, check with payers before submitting the codes.

You may need to send the insurance representative proof of the new codes. Put this in your letter: The AMA accepted codes 90650, 90681, and 90696 at the June 2007 CPT Editorial Panel meeting for the 2009 CPT production cycle. "Therefore, these codes will not appear in the 2008 CPT code book," according to information that the AMA provided on vaccine codes. But these codes are effective on Jan. 1, 2008.

Check out the AMA's notification online at

http://www.ama-assn.org/ama1/pub/upload/mm/362/vaccinecodes.pdf.

Useable but not-in-print codes include:

- 90650 -- Human Papillomavirus (HPV) vaccine, types 16 and 18, bivalent, 3 dose schedule, for intramuscular use

- 90681 -- Rotavirus vaccine, human, attenuated, 2 dose schedule, live, for oral use

- 90696 -- Diphtheria, tetanus toxoids, acellular pertussis vaccine and poliovirus vaccine, inactivated (DTaP-IPV), when administered to children 4 years through 6 years of age, for intramuscular use.

Note: A lightning bolt symbol, which indicates the vaccines are awaiting approval from the FDA, precedes these codes.