AAPC - Back to school
Results 1 to 5 of 5

Thread: Coding HPV vaccine in Pediatrician office

  1. #1
    Join Date
    Apr 2007

    Unhappy Coding HPV vaccine in Pediatrician office

    AAPC: Back to School

    Could someone help me? I am new to coding... When a patient comes in the office and received an HPV vaccine and the Physician counsel the patient and family. What code would I use for the counselng part of it? I am at a lost because in the CPT Manual there are counseling codes only for children younger the eight years of age.

    Is there any counseling codes for children above the age of 8 years of age? And my next question is when using a dx code for the HPV which is the difference between V04.89 and V05.8 I' m at a lost. And if there is not a procedure code for the couselng part of it would I be safe, billing with a dx code V65.9 which is Unspecified reason for consultation?:

    Final question, when a patient comes in the office for other problems but received a vaccine. How would you code? because with some insurance companies if you bill a 99213 with a Vcode there are times where the claim will either deny because youre billing an office code 99213 with a preventive dx code. Or the claim will be paid but when you actually bill a well visit it may deny because the pt is limit to a certain amount of preventive care.

    Could someone please help me I;m at a lost.


    Linda B

  2. #2

    Default Administration Code with Vaccine Code

    I too am new to coding. I just reviewed some office fee tickets and they do not have ANY administration codes on them--in other words, they have been billing for the vaccine, but never the ADMINISTRATION of the vaccine. I am sure that this can't be correct. I realize through the Vaccines for Children program, the vaccine is provided free, and I believe we get $5 for the administration, but commercial payers have not been billed for administration, or the VFC program....Can someone help me please? The only other way I can find out is asking the payers, and I really don't want to look that stupid!

  3. #3
    Join Date
    Apr 2007
    north seattle wa


    For the counseling with the HPV vaccine I would look at 99401 and V65.45 and use these in addition to the admin and serum codes. Just note that 99401 is for 15 minutes.

    As for the vaccination at a problem visit, you should be attaching the problem dx to your E&M code and only use the V codes for that admin and serum codes for the vaccination.

    Hope this helps


  4. #4
    Join Date
    Apr 2007


    Hello - I will just give you some advice on the HPV vaccine. I went through an ordeal on the patient end and coding end when I took the vaccine myself. Your vaccine code is 90649 for Gardasil, it took the V04.89 to get all three of my claims paid. I also had an issue with an office visit being billed in conjunction with the vaccine so if you get a denial on that vaccine or counseling code, I ended up having to split the claim so the diagnosis code for the office visit didn't interrupt the HPV vaccine, this particular insurance was a pain! Hope your payor proves better! Good Luck!!

  5. #5
    Join Date
    Apr 2007
    Alexandria, VA

    Smile Coding HPV vaccine in Ped office

    Linda B, (and others)
    I have been billing for Peds for several years. If you call me, I will walk you thru how to bill your Prev visit, problem visit, vacc, and adm altogether and get PAID....


Similar Threads

  1. 90650 hpv vaccine
    By ebyb in forum Medical Coding General Discussion
    Replies: 8
    Last Post: 10-31-2013, 07:43 AM
  2. HPV vaccine administration help
    By abradshaw in forum Family Practice
    Replies: 3
    Last Post: 01-22-2013, 12:21 PM
  3. HPV Vaccine 90649
    By julieclifton2011 in forum OB/GYN
    Replies: 3
    Last Post: 04-15-2011, 06:02 AM
  4. hpv vaccine
    By efuhrmann in forum Diagnosis Coding
    Replies: 2
    Last Post: 10-30-2009, 08:00 AM
  5. Counseling for HPV Vaccine
    By lmcbrayer in forum Family Practice
    Replies: 1
    Last Post: 01-19-2008, 10:14 PM

Posting Permissions

  • You may not post new threads
  • You may not post replies
  • You may not post attachments
  • You may not edit your posts

Enjoying Our Forums?

AAPC forums are a benefit of membership. Joining AAPC grants you unlimited access, allowing you to post questions and participate with our community of over 150,000 professionals.

Join Now Continue Reading Without Full Access

Already a Member?


Close Message

In addition to full participation on AAPC forums, as a member you will be able to:

  • Access to the largest healthcare job database in the world.
  • Join over 150,000 members of the healthcare network in the world.
  • Be a part of an industry leading organization that drives the business side of healthcare.
  • Save anywhere from 10%-50% with exclusive member discounts on courses, books, study materials, and conferences.
  • Access to discounts at hundreds of restaurants, travel destinations, retail stores, and service providers. AAPC members also have opportunities to save on heath, life, and liability insurance.
  • Become a member of a local chapter and attend regular meetings.