Wiki Rotavirus Vaccine CPT

[cstoldt]

I have denial for CPT 90680 for RotaTeq based on age. The child was 9 months old. They said to rebill with a different CPT but I see no other CPT to use. This is the third in a series of 3 and the first 2 have been paid. Any ideas on what CPT to bill?

 

[BABS37]

Found this on supercoder. Says must be given by 8 months in age... Maybe that's why the third one got denied?

For the 3-dose vaccine, the first dose typically is given to the infant at 2 months of age. The second dose is then given at 4 months of age, and the third dose is given at 6 months of age. The first vaccine dose can be given as early as 6 weeks of age or as late as 14 weeks, 6 days of age. Vaccination should not be started for infants once they reach 15 weeks of age. There must be 4 weeks between doses and all doses must be given by 8 months of age.

 

[ajs]

Found this on supercoder. Says must be given by 8 months in age... Maybe that's why the third one got denied?

For the 3-dose vaccine, the first dose typically is given to the infant at 2 months of age. The second dose is then given at 4 months of age, and the third dose is given at 6 months of age. The first vaccine dose can be given as early as 6 weeks of age or as late as 14 weeks, 6 days of age. Vaccination should not be started for infants once they reach 15 weeks of age. There must be 4 weeks between doses and all doses must be given by 8 months of age.

If there was a good reason why the final dose was delayed, maybe you can appeal the denial. I would definitely give it a try.

 

[cstoldt]

Thank's for the information. It was very helpful. Turns out the child was sick and third imunnizations were held in March . But they rescheuled to far out and could maybe have done this in April or May instead of waiting til June when it was too late.