News

Sanofi Pasteur Update - May 2013 - 5/6/2013
Because the availability of pediatric pertussis-containing combination vaccines has been further constrained, Sanofi has decided to reinstate order allocations for Daptacel® vaccine in an effort to responsibly manage existing supply.

Update Regarding National Correct Coding Initiative (NCCI) Edits Effective January 1, 2013 - 2/1/2013
On Friday, February 1, an alert was sent to all state Medicaid agencies from the Centers for Medicare and Medicaid Services (CMS) allowing each state the opportunity to deactivate the NCCI edit on preventive medicine service codes and immunization administration codes retroactive to January 1. The deactivation of this edit is only applicable for the first quarter of 2013 (i.e, January 1 - March 31, 2013). CMS will not make any unilateral decisions to deactivate this NCCI edit nationally at this time but rather each state will decide whether to deactivate the edit in its Medicaid program and whether to reprocess claims retroactive to January 1.

The AAP encourages providers to reach out to their state’s Medicaid office voicing their support for the deactivation of this edit and reprocessing of claims retroactive to January 1 to ensure pediatricians are paid for work performed.

AAP Guidance Regarding National Correct Coding Initiative (NCCI) Edits Effective January 1, 2013 - 1/29/2013
On January 1, 2013 the Centers for Medicare and Medicaid Services (CMS) released the latest version of the National Correct Coding Initiative (NCCI) edits.

Included in this version were edits on all evaluation and management (E/M) services that disallow patient with immunization administration codes without the proper modifier.

The AAP is working with CMS to suspend the edits on all preventative medicine service codes with immunization administration codes.

In the meantime, for all claims submitted after January 1, 2013, it is recommended to append modifier 25 to the preventive medicine service code (99381-99395) when it is reported in conjunction with any immunization administration service (90460-90461; 90471-90474).

Please note that while the edits are published by CMS, many private insurers also follow these guidelines.

Please click the following link for more information:
http://www.aap.org/en-us/professional-resources/practice-support/coding-resources/Pages/NCCI-Letter-Vaccine-Administration.aspx


For OB/GYN Providers: New CDC Recommendations for the Immunization of Pregnant Women - 1/1/2013
The 2013 Adult Immunization Schedule issued by the CDC recommends that pregnant women get Tdap vaccine with each pregnancy to increase protection for infants who are too young for vaccination but at highest risk for severe illness and death from pertussis. Please click here for more information: http://www.cdc.gov/vaccines/schedules/downloads/adult/adult-schedule-easy-read.pdf