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Coding for Hepatitis B

  1. #1
    Exclamation Coding for Hepatitis B
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    My family medicine nurses are combing 2 Pediatric Hep B vaccines to equal 1 Adult dose and they want me to bill out the 90746. They said they have been doing this for years, I just started coding for this specific department (I usually do IM) and I don't agree with this, they are giving Pediatric dosage not adult. Am I correct on not using the 90746 and telling them we can bill this service out? We don't have a shortage, so there is not excuse to use pediatric Hep B.

    Please Help as I had a big argument with the nurse since in I refuse to bill this out.

  2. Default
    I agree with you completely, I would not code it as an adult dosage. I would use 90471 (the administration of a vaccine) and then 90743 x2 OR 90744 x2. I am leaning more towards 90743 because even though it is reffered to as adolescent, not pediatric, it says 2 doses scheduled. Which makes me think that is the proper dosage where 2 combined would equal to one adult dose.
    Hopefully that helps a little.. =/

  3. Default
    Nurses who think they know more about coding...get on my last nerve. I would not code as adult either. It's not accurate...sigh. Nurses need to stop telling coders how to do our job.

  4. #4
    Even if I bill out the 90743 x2 OR 90744 x2 this patient is 67 and he has Medicare the clearing house would throwing it out and the patient would have to be responsible for the charges.

    Oh yeah she got real bucky with me, got compliance involved, but I have searched everywhere and I can't find where they give 2 ped dose to equal 1 adult dose. I have asked a nurse in the IM dept and she doesn't agree with their practice. I will have to see what compliance has to say now.

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