GURU Application * On-Line Support

Immunization Tracking
last updated September 9, 1999

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Immunization records are available on-line through the Primary Care Center's GURU application for display, analysis, and printing. The immunizations are entered into the database through a process of uploading ICD-9 codes. Specifically:

  • Administered immunizations are marked on a Primary Care Center Charge Requisition Form.

  • The associated ICD-9 codes are entered into the hospital billing system (SMS).

  • On a weekly basis, SMS automatically generates a report which searches through all patients entered from a defined, recent 2-week period, selects those who have been seen in a Primary Care Center clinic (including Braddock, Turtle Creek, Wilkinsburg, and FIC) plus any other additional children who have received immunizations within the hospital system (thereby having billing information entered), and saves all relevant information to a download file.

  • This weekly download file is available for processing by GURU to upload the report information into all of the appropriate clinical database fields, which includes not only immunizations but also problem lists, insurance info, and demographic info.
The primary advantage to this method is that it eliminates the need for additional data entry into an immunization tracking system, since information can be extracted from billing codes which would be entered anyway.

There are, however, several disadvantages:

  • There is a delay between when the immunization is administered and when it appears in the GURU database. This could be up to 2-3 weeks, depending on how long it takes for the billing information to be entered, and how long after that it appears in a SMS report file.

  • Additional immunization information which may need to be tracked is not captured: manufacturer, lot number, etc.

  • ICD-9 codes are rather patchwork in nature, usually behind the times and minimally satisfactory to represent the current broad spectrum of immunizations. Some vaccines need to be coded as "Unspecified" or "Other". There are also no distinctions between "DTP" and "DTaP" or "OPV" and "IPV" or the various kinds of "Hib" vaccines.

    The following table illustrates some of the current vaccine-relevant ICD-9 codes. Not all vaccines or ICD-9 codes are listed - just the ones usually encountered in a clinic setting:

ICD-9 Code ICD-9 Description
V03 Need for prophylactic vaccination and inoculation against bacterial diseases
V03.5 Diphtheria alone
V03.6 Pertussis alone
V03.7 Tetanus toxoid alone
V03.8 Other specified vaccinations against single bacterial diseases
V03.81 Hemophilus influenza, type B [Hib]
V03.82 Streptococcus pneumoniae [pneumococcus]
V03.89 Other specified vaccination
V03.9 Unspecified single bacterial disease
V04 Need for prophylactic vaccination and inoculation against certain diseases
V04.0 Poliomyelitis
V04.8 Influenza
V05 Need for prophylactic vaccination and inoculation against single diseases
V05.3 Viral Hepatitis
V05.4 Varicella
V05.8 Other specified disease
V05.9 Unspecified single disease
V06 Need for prophylactic vaccination and inoculation against combinations of diseases
V06.1 Diphtheria-tetanus-pertussis, combined [DTP]
V06.3 Diphtheria-tetanus-pertussis with poliomyelitis [DTP+polio]
V06.4 Measles-mumps-rubella [MMR]
V06.5 Tetanus-diphtheria [Td]
V06.8 Other combinations
V06.9 Unspecified combined vaccine
V07 Need for isolation and other prophylactic measures
V07.2 Prophylactic immunotherapy
V07.8 Other specified prophylactic measure

If the download method of immunization data entry is continued at CHP, the accuracy and integrity of the ICD-9 codes on the Charge Requisition Form is critical for the successful creation of valid patient immunization records.

The following table summarizes past and present ICD-9 immunization codes and includes proposals for changes to the current (7/99) Charge Requisition Form which will help maintain this data integrity.

Immunizations on
7/99 Charge Form
Code(s) on
Previous Form
(dated 5/6/97)
Code(s) on
Current Form
(dated 7/99)
Proposed ICD-9 Code(s) and Reason(s)
Comvax (none) V03.89 & V05.3 V03.81 & V05.3
New code specifically for Hib
DT V03.5 & V03.7 V03.5 & V03 V06.5
New code specifically for DT combination
DTaP V06.1 V06.1 (<-- same)
DTP V06.1 V06.1 (<-- same)
Hep A (none) V05.3 V05.9
Using 'Unspecified' to differentiate from HepB
Hep B V05.8 V05.3 (<-- same)
Hib V03.8 V03.89 V03.81
New code specifically for Hib
Influenza V04.8 V04.8 (<-- same)
IPV V04.0 V04.0 (<-- same)
Meningococcal V02.5 V02.5 V03.9
Current code is for a carrier of meningococcus
Using 'Unspecified' for improved accuracy
MMR V06.4 V06.4 (<-- same)
OPV V04.0 V04.0 (<-- same)
Pneumococcal V06.9 V06.9 V03.82
New code specifically for Pneumococcus
PPD V74.1 V04.1 V74.1
Correction of typo in current form
(V04.1 is for Smallpox vaccination!)
Rotavirus (none) V05.8 (<-- same)
Synagis (none) V05.8 V07.2
More accurate description of product
Differentiates from Rotavirus coding
Td V03.5 & V03.7 V03.5 & V03.7 V06.5
New code specifically for DT combination
Tetramune V06.1 & V03.8 V06.1 & V03.89 V06.1 & V03.81
New code specifically for Hib
Varicella V05.4 V05.4 (<-- same)
VZIG V07.8
An appropriate code for therapy
Differentiates from Synagis coding