PPV 23 given to patient under age 2. 90732

LOUISE SLACK

Networker
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Hello,

Has anyone had a provider give Pneumovax 90732 to an immunosuppressed patient under age 2? Our provider gave it to a 20 month old and now our edits say we cant bill it because of the age limit.

I'm thinking billing the Prevnar 90670 but that's not an exact match and to bill an unlisted procedure code just because of the age limit doesn't seem right either.

What would you do?

Thank you,
Louise
 

CodingKing

True Blue
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Its not FDA approved for that age so you are likely out of luck:

Pediatrics: PNEUMOVAX 23 is not approved for use in children younger than 2 years of age because children in this age group do not develop an effective immune response to capsular types contained in the polysaccharide vaccine.
 
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