CMS 117v10: Childhood Immunization Status

CPT: 99201, 99202, 99203, 99204, 99205, 99211, 99212, 99213, 99214, 99215, 99341, 99342, 99343, 99344, 99345, 99347, 99348, 99349, 99350, 99381, 99382, 99383, 99384, 99391, 99392, 99393, 99394, 98969, 98970, 98971, 98972, 99421, 99422, 99423, 99458, 98966, 98967, 98968, 99441, 99442, 99443

HCPCS: G0071, G2010, G2012, G2061, G2062, G2063

SNOMED CT codes must be added as a Favorite in Preferences > Form Data > Orders to be accessible from the Orders/Referrals tab.

• DTap, Hib (3 or 4 dose), PCV, IPV, and RV ( 2 or 3 dose) vaccines must be administered from 42 days of age up to 2 years old.

• Flu vaccines must be administered from 180 days of age up to 2 years old.

  • If administering the LAIV flu vaccine, the LAIV must be administered on the date of the patient's 2nd birthday.

1. Go to Encounters > Immunizations > 0 to 2 tab
2. Click the immunization name/dose button

   1. For Influenza, click the Add button

      

3. Complete the fields in the Serum section

4. Complete the applicable fields of the Administration section

   

5. Click Save

1. Go to Encounters > Immunizations > 0 to 2 tab
2. Click the immunization name/dose button
   1. For Influenza, click the Add button
3. Select the Historic checkbox
4. Document the date the immunization was given in the Date field of the Administration section
5. Click Save

Note

If documenting H influenza type B (Hib) as a historical immunization, four entries must be documented unless a Tradename for a three-dose vaccine is selected. If documenting rotavirus (RV) as a historical immunization, three entries must be documented unless a Tradename for a two-dose vaccine is selected.

A patient’s history of the disease or allergic reaction to a vaccine can be documented in the Assessment tab of an encounter. A comprehensive list of eligible diagnosis codes for these conditions can be located here.

Note

Some of the eligible diagnosis codes for the following conditions are only available as SNOMED CT codes. SNOMED codes can be added in the Assessment tab by mapping the codes to an active ICD-10 using the Map SNO button.

Eligible DTap Conditions

• Diagnosis of Anaphylactic Reaction to DTaP Vaccine
• Diagnosis of Encephalopathy due to Childhood Vaccination

Eligible IPV Conditions

• Diagnosis of Adverse Reaction to Vaccine Product Containing Human Poliovirus Antigen
• Diagnosis of Streptomycin Adverse Reaction
• Diagnosis of Polymyxin B Adverse Reaction
• Diagnosis of Neomycin Adverse Reaction

Eligible MMR Conditions

• Diagnosis of Disorders of the Immune System
• Diagnosis of HIV
• Diagnosis of Malignant Neoplasm of Lymphatic and Hematopoietic Tissue
• Diagnosis of Neomycin Adverse Reaction
• Diagnosis of Measles
• Diagnosis of Mumps
• Diagnosis of Rubella

Eligible Hib Conditions

• Diagnosis of Anaphylaxis due to Haemophilus Influenzae Type B Vaccine

Eligible Hep B Conditions

• Diagnosis of Anaphylaxis due to Hepatitis B Vaccine
• Diagnosis of Anaphylactic Reaction to Common Baker's Yeast
• Diagnosis of Hepatitis B

Eligible VZV Conditions

• Diagnosis of Disorders of the Immune System
• Diagnosis of HIV
• Diagnosis of Malignant Neoplasm of Lymphatic and Hematopoietic Tissue
• Diagnosis of Anaphylactic Reaction to Neomycin
• Diagnosis of Varicella Zoster

Eligible PCV Conditions

• Diagnosis of Adverse Reaction to Vaccine Product Containing Streptococcus Pneumoniae Antigen

Eligible Hep A Conditions

• Diagnosis of Adverse Reaction to Vaccine Product Containing Hepatitis A Virus Antigen
• Diagnosis of Hepatitis A

Eligible RV Conditions

• Diagnosis of Anaphylaxis due to Rotavirus Vaccine
• Diagnosis of Severe Combined Immunodeficiency
• Diagnosis of Intussusception

Eligible Flu Conditions

• Diagnosis of Adverse Reaction to Vaccine Product Containing Influenza Virus Antigen
• Diagnosis of Malignant Neoplasm of Lymphatic and Hematopoietic Tissue
• Diagnosis of Neomycin Adverse Reaction
• Diagnosis of HIV
• Diagnosis of Disorders of the Immune System