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kbarron

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I am looking for any official document regarding 90649 and 90650 stating that these are gender specific codes. Also, we are having a contraversy about state supplied vaccines. I understand that through age 18 means up to their 19th birthday. I am getting information stating through 18 means aged 18 and 1 day. I am looking through he internet and finding a myriad of answers. Thought I would go here to get expert advice. Thanks in advanced for all your help.
 
I honestly think that both topics are payer specific. Although the HPV can be administered to boys, it's kind of an 'off label' use.
And we always bill out the kid's vaccines until age 19, but sometimes we end up having to re-code, depending on the payer. I don't think there's one answer.
Most payers have coverage information online, or you can contact your payer rep directly.
 
Hi
Try the CDC website also for specific information on these two immunizations. I belive payors go by what is recommended from the CDC where vaccines are concerned.:)
 
You are correct about the age for state supplied vaccines if this is through the Vaccines for Children program. The following is found at http://www.cdc.gov/vaccines/programs/vfc/about/index.html.

A child is eligible for the VFC Program if he or she is younger than 19 years of age and is one of the following:
•Medicaid-eligible
•Uninsured
•Underinsured [1]
•American Indian or Alaska Native

Children whose health insurance covers the cost of vaccinations are not eligible for VFC vaccines, even when a claim for the cost of the vaccine and its administration would be denied for payment by the insurance carrier because the plan's deductible had not been met.

Hope this helps.
Cindy
 
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