Hep B Vaccine

jeannie1977

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If an adult patient comes in for a two series shot of the Hep B shot, and the pediatric vaccine is given as a double dosage, would you bill the 90746 because the patient is an adult, or two units of the 90744 since the vaccine came from the pediatric vaccine vial? Per the office manager they do not have enough patients to support having the adult vaccine on hand, so their solution is to double the pediatric vaccine.

90746 X 1 unit (adult code)
90744 X 2 units(pediatric code)
 

jeannie1977

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We are getting a denial from Anthem, which is why the biller has found that this is their current practice. Anthem is denying stating that the patient is to old, and due to the denial this entire scenario now comes into question on if and how this should be coded out.
 
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Did you ever figure out what to do? I am having the same scenario with BCBS and we billed the 90744 with two units.
 

erjones147

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I don't think I would bill it at all. You can't use the adult code because I don't think the lot numbers would match up in case of a recall or an adverse reaction, and no way are the insurance companies going to deal with billing 2 units of a pediatric shot for an adult
 
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