New and Revised Vaccine and Category III codes

The AMA’s new and revised vaccine and Category III codes? If not, slow down and take a closer look.

CPT codes, CPT 2011, CPT code list, Medical Coding, CPT coding

Have you read through the AMA’s new and revised vaccine and Category III codes? If not, slow down and take a closer look. Check the updated status classifications for various vaccine codes and gear up to use them now that the FDA has given the go ahead.

Code 90650 gathers FDA Clearance

In October last year, the AMA published a new code for Human Pailloma virus (HPV) vaccine on its website. CPT codes does not include 90650, however you have been able to report it following payer guidelines.

The CPT coding process allows for development of new codes and numbers; however they don’t become active until FDA approved. New codes might be included in CPT, however have a lightning bolt symbol designating pending FDA approval.

Change of status: The latest coding information from AMA does away with the lightning bolt symbol from 90650, effective back to the FDA approval date of Oct. 16, 2009. You’ll get 90650 in CPT 2011 as a fully approved code.

Most payers will not pay for vaccines until they are FDA approved. Even after approval, there can be a lag time from three to six months until payers pick up on the fully approved code.

Most payers will not shell out money for vaccines until they are FDA approved. Even after approval, there can be a lag time from three 3 to 6 months until payers pick up on the fully-approved code.

According to many, if the code is not indicated in the CPT book yet, many carriers will not recognize the code. They will give you an ‘invalid code’ denial, even though you can officially use the code.

But the good news is, once news of code 90650’s FDA approval spreads, you should be able to file claims unhindered.

Source URL :- http://www.supercoder.com/coding-newsletters/my-pediatric-coding-alert/category-iii-codes-shift-90650-hpv-vaccine-from-pending-to-approved-list-of-choices-article