Reminder: Immunization follow up should be conducted by age 2


Date: September 22, 2021
To: Health Plan of San Joaquin (HPSJ) Contracted PCPs, Clinics, Pediatrics Offices
From: Health Plan of San Joaquin
Subject: Child Immunization Status UPDATE –
Reminder: Immunization follow up should be conducted by age 2
Business: Medi-Cal Managed Care

SUMMARY FOR MEASURE YEAR (MY) 2021
Childhood Immunization Status: Combination 10

Providers, please be aware of child HPSJ members turning two years of age before November 2021. 

Please remember:

  • Report all Administered Vaccines into the RIDE (preferred) or CAIR 2 registry within 14 days
  • Document the date of the first hepatitis B vaccination – if given at a hospital please note the hospital’s name

Added for 2020-2021:

  • The requirement that if the LAIV (influenza)vaccination is given it must occur ON the child’s second birthday.

Most common deficiencies in coding and billing occur with: 

  • (Hep B) hepatitis B at birth
  • (RV) Rotavirus 2 dose vs (RV)Rotavirus 3 dose

The Childhood Immunization Status (Combination 10) Measure calculates a rate for each vaccine and ten separate combination rates. These, including billing codes, are listed below. 

All Required Vaccines Before 2nd Birthday 

  1. 4 –(DTaP) diphtheria, tetanus and acellular pertussis. CPT– 90698,90700,90723
  2. 3- (IPV) polio, CPT– 90698,90713,90723
  3. 1- (MMR) measles, mumps and rubella, CPT– 90707,90710
  4. 3- (Hib) haemophilus influenza type B, CPT– 90644,90648,9698,90748
  5. 3 -(Hep B) hepatitis B, CPT– 90723,90740,90744,9074790748
  6. 1- (VZV) chicken pox, CPT– 90710,90716
  7. 4- (PCV) pneumococcal conjugates-CPT– 90670
  8. 1- (Hep A) hepatitis A, CPT– 90633
  9. 2/3- (RV) rotaviruses; 2 dose_CPT– 90681 or 3 dose_CPT– 90680
  10. 2- (flu) influenza vaccines, CPT- 90655,90657,90662,90673,90685,90686,90688,90689

If you have questions, please contact Provider Services at 1.888.936 PLAN (7526).

Posted on September 22nd, 2021 and last modified on September 8th, 2022.

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