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ICD-9-CM for Pentacel in 2011

  1. Question ICD-9-CM for Pentacel in 2011
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    The AAP's FAQ for 2011 Pediatric Immunization Administration Codes states in response to one question:

    Under the new pediatric immunization administration codes, those vaccines that contain multiple components that now require two distinct ICD-9-CM codes (eg, Pentacel® is reported with both V06.3 and V03.81) will be reported with one ICD-9-CM code: V06.8.

    This guideline was revised due to the significant administrative burden it would have caused for the physician or other qualified healthcare professional to have to know which vaccine components are linked to which ICD-9-CM code. While ICD-9-CM guidelines do require coding to the greatest specificity, in this case it is too burdensome. Please refer to the Academy's Vaccine Coding Table in Attachment A below for more information.

    When I review the Vaccine Coding Table referenced in the above response, I see that the ICD-9-CM codes for Pentacel are still listed as V06.3 plus V03.81.

    Which is correct for 2011, the information in the question response (i.e. use only V06.8) or the information in the Vaccine Coding Table?

  2. #2
    Somers Point New Jersey
    Thumbs up Pentacel ICD-9 code
    In my opinion the correct ICD-9 code for Pentacel is V06.8 as it states

    V06.8 - Need for prophylactic vaccination and inoculation against other combinations of diseases

    While CPT 90698 is combination of Diptheria, Tetanus toxoids , acellular pertusis, Haemophilus influenzae type B & poliovirus vaccine . ( DTaP-Hib-IPV ).

    V06.3 would not be the correct ICD-9 code for CPT 90698 because it describes " Need for prophylactic vaccination and inoculation against [ DTaP + polio ]. The description excludes Hib.

    Also V03.81 would not be the correct ICD-9 code for CPT 90698 because it describes " Need for prophylactic vaccination and inoculation against Haemophilus influenzae type B. The description excludes [ DTaP + polio ].

    Hope this helps

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