Results 1 to 6 of 6

90696 for less than 4 years old

  1. Default 90696 for less than 4 years old
    Medical Coding Books
    90696 is a new code in 2009 but what about if the patient is less than 4?

  2. #2
    North Carolina
    It seems you have to use an unlisted code...Any other takers?

    You Be the Coder: DTaP-IPV Booster Receives Own Code

    Question: What is the CPT code for Kinrix?

    Answer: You should use new code 90696 (Diphtheria, tetanus toxoids, acellular pertussis vaccine and poliovirus vaccine, inactivated [DTaP-IPV], when administered to children 4 through 6 years of age, for intramuscular use) with V06.3 (Need for prophylactic vaccination with diphtheria-tetanus-pertussis with poliomyelitis [DTp + polio] vaccine). CPT 2009 established the code to report a combination vaccine to protect against pertussis (whooping cough), diphtheria, tetanus, and poliomyelitis (polio) in a single injection.

    Kinrix combines the DTaP (diphtheria, tetanus toxoids, and acellular pertussis) and IPV (poliovirus inactivated) vaccines. You previously had no code that represented this combination. Because CPT disallows coding each component of a combination vaccine separately, such as reporting the DTap portion with 90700 (Diphtheria, tetanus toxoids, and acellular pertussis vaccine [DTaP], when administered to individuals younger than 7 years, for intramuscular use) and the IPV component as 90713 (Poliovirus vaccine, inactivated [IPV], for subcutaneous or intramuscular use), you had to use an unlisted procedure code (meaning 90749, Unlisted vaccine/toxoid), per CPT’s "Vaccines, Toxoids" instructions.

  3. #3

    "Safety and efficacy not established in children younger than 4 yr of age or children 7 to 16 yr of age."

    According to this it is not meant for any other age range.

    Laura, CPC, CEMC

  4. #4
    North Carolina

    What was your vaccination combination?

  5. #5
    North Carolina
    Indications and Guidance for Use

    DTaP-IPV (Kinrix) is indicated for use as the fifth dose of DTaP and fourth dose of IPV in children aged 4 -- 6 years who received DTaP (Infanrix) and/or DTaP-Hepatitis B-IPV (Pediarix) as the first 3 doses and DTaP (Infanrix) as the fourth dose (1,2). This vaccine should not be administered to children aged <4 years or >7 years; however, if DTaP-IPV (Kinrix) is inadvertently administered for an earlier dose of the DTaP and/or IPV series, the dose should be counted as valid and does not need to be repeated provided minimum interval requirements have been met (5). Data are limited on the safety and immunogenicity of interchanging DTaP vaccines from different manufacturers (6). ACIP recommends that, whenever feasible, the same manufacturer's DTaP vaccines should be used for each dose in the series; however, vaccination should not be deferred because the type of DTaP previously administered is unavailable or unknown (6).

    If it is inadvertently administered, would this be payable? Anyone know?

  6. Default
    I have a patient who was 2 days shy of his 4th birthday, when he got this 90696, which is denying "due to patient's age". Is there any way to get this paid? I'm not seeing it. I don't see any other immunization combo that fits, for younger than age 4 (and he's still 3years old until he's 4!) It looks like the denial is going to stick, unless someone has an idea for me. Thank you.

Similar Threads

  1. 90696
    By gmlittle in forum E/M
    Replies: 2
    Last Post: 05-16-2013, 10:36 AM
  2. 90696 for 8 year old
    By ridenut in forum Pediatrics
    Replies: 0
    Last Post: 04-23-2013, 08:54 AM
  3. vaccine 90696 medicaid denial
    By jijikaren in forum Pediatrics
    Replies: 4
    Last Post: 12-01-2011, 12:32 AM
  4. Replies: 0
    Last Post: 06-03-2011, 02:45 AM
  5. 1-2 years of experience
    By Eddie in forum Resume Postings
    Replies: 0
    Last Post: 08-07-2009, 03:50 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.