90650 hpv vaccine

ebyb

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Quick question coders,
When coding 90650, 3 dose schedule, is 90650 coded for every visit along with administration or just the initial visit, admin and then administration only the next two visits?
I have discussed this with my team and management but we all have different answers.
Thanks for your help :D

Eby CPC-A
 

Biller385

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I agaree with Bill. Also remember to check if counseling was done by the physician and the patient is 18 years or younger for the correct admin code.

Cathy
 

ebyb

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Hmmm? I wonder if this code is Payer Specific? One of our billers noticed Community Care is paying for 90650 each time? Is there any resources I could reference? In the mean time I will research more about United Healthcare because they are the ones denying the claim. I got my hands on a 2012 CPT book but it is funny how many ways this could be read.
 

Biller385

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Uhc had at one time an area on their website where you could put in the code to see they would pay them. Was a preventative exam also done at the same time? At one point they wanted the 25 modifier on the preventative exam before they would pay the claim. They don't follow the CCI edits. They have their own. Also check to see if your patient's policy covers this vaccine.

Cathy
 
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