Vaccinations

[Connie Morrison]

I came across this on a practice exam and would like clarification on the answer:

Patient presents for an influenza vaccination and pneumococcal vaccination. Each vaccine was in a seperate vial and was administered individually.

A. V04.8, V03.89
B. V04.7, V03.82
C. V04.81, V03.82
D. V06.6

I had chosen C and the answer was D (combo code). I can't find anything in the guidelines except 1 note on pg. 1060 in the 2012 ICD9 book under V06 which says "use additional single vaccination codes from categories V03-V05 to identify any vaccinations not included in a combination code.

Does this mean if a combo vaccination code is available, you should always code the combo code even though the question says "seperate vials and administered individually"?

Thanks,
Connie

 

[Ruth Sheets]

Well, I would have gotten this wrong, too, but thinking it over this is what I think is the rationale.

The person is coming in to receive prophylactic vaccination for two diseases, namely, influenza and streptococcus pneumoniae. So the V combination code fits because the person has a need for vaccination and inoculation against the combination of diseases. Whether the vaccinations are delivered by one of two vials is irrelevant to the diagnosis code, but would be relevant to the CPT code.