Wiki vaccine billing


Lakeville, IN
Best answers
Is it possible if an adult is 19 and older and they come in for a Hep A vaccine and the only vaccine in stock is the ped/adolescent vaccine are you able to give the pt that but instead of giving them the ped dose give them the adult dosage?

You have two issues with this: A billing issue and a medical issue.

First, you will most like not get paid. I bill vaccines daily and when a vaccine is given off-schedule for any reason payment is denied ("inconsistent with age" or some such wording). If you bill for two pediatric doses with the pediatric dose NDC code (if the carrier requires it) you will most likely be shot down in flames. You could make an argument for billing an adult dose since you are "making one" in the kitchen ... but I don't have a warm fuzzy about that.

Medically, you could try having the physician look at the product insert and see what it says. But if it's not spelled out (I don't see it on the Merck product insert) you would need to call the vaccine manufacturer and ask. Interestingly, I found on the Merck website were they specifically says that's ok for Hep B ... but doesn't say one way or another on the Hep A page. Perhaps the proportions are different or they just didn't spell it out.

The only way to be "sure" would be to call the vaccine manufacturer.