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Immunizations for Adolescents

EHP, Priority Partners, and USFHP. Adolescents 13 years of age during the Measurement Year.

Adolescents 13 years of age who had one-dose of meningococcal vaccine, one-dose tetanus, diphtheria toxoids and acellular pertussis vaccine (Tdap) and completed the human papillomavirus (HPV) vaccine series by their 13th birthday.

Combo 1:

  • 1 dose – Meningococcal conjugate or meningococcal polysaccharide vaccine on or between the member’s 11th and 13th birthdays.
  • 1 dose – Tetanus, diphtheria toxoids vaccine, and acellular pertussis vaccine (Tdap) on or between the member’s 10th and 13th birthdays.

Combo 2 (includes above combo 1 immunizations plus the following):

  • 2 dose series or 3 dose series of the HPV (human papilloma virus) vaccine with different dates of service between the members 9th and 13th birthdays.

Best Practice and Measure Tips

  • Immunization must occur on or prior to the member’s 13th birthday.
  • Document any parent refusal for immunizations, as well as anaphylactic reactions. This will not exclude the member from this measure.

Acceptable documentation:

  • A note indicating the name of the specific antigen and the date of the immunization.
  • A certificate of immunization prepared by an authorized health care provider or agency including the specific dates and types of immunizations administered.

Not acceptable:

  • A note the "member is up to date" with all immunizations but does not list the dates and names of all immunizations.
  • Meningococcal recombinant (serogroup B) (MenB) vaccines.

Measure Exclusions

Required Exclusion: Hospice

Optional Exclusions:

  • Any vaccine-Anaphylactic reaction to the vaccine or its components any time on or before the member's 13th birthday or with a date of service prior to October 1, 2011.
  • Tdap-Encephalopathy anytime on or before the member's 13th birthday.
  • Contraindicated adolescents may be excluded only if administrative data does not indicate that the contraindicated immunization was rendered.

Measure Codes

  • Meningococcal-serogroup A,C,W, and Y(1 dose)
    • CPT: 90734
    • CVX: 108, 114, 136, 147, 167
  • Tdap (1 dose)
    • CPT: 90715
    • CVX: 115
  • HPV (2 or 3 dose series)
    • CPT: 90649 – 90651
    • CVX: 62, 118, 137, 165