Pneumovax

My doctor keeps ordering Pneumonia vaccine 90732 on pt's that are not 65. Most of these pt's have asthma which my doc says meets the guidelines for payment. However I keep getting denials. Does anyone have the same problem or any suggestions.

re: Pneumovax

Try using V03.82 if Medicare patient can be done once in a lifetime. Does not give an age restriction and can be done again in 5 years if high risk.

re: Pneumovax

Aetna: Adults aged 19 through 64 years who have asthma - allowed diagnosis
Some instances of medical necessity will include age over 65 years with respiratory issues like asthma or COPD; patients with other medical conditions like congestive heart failure, cirrhosis, diabetes mellitus; and patients who are immunosuppressed (due to chemotherapy, HIV, after organ transplantation, or currently on immunosuppressive drugs).

Diagnosis: V03.82