Precheck disposition codes
These dispositions are made on rows of immunization data during the precheck sequence. Some errors only exist for certain EMRs and may not apply to your practice.
Codes 51 and 52
Codes 51 and 52 are not technically errors and thus technically do not require correction.
51: TB skin test. Some EMRs generate vaccine data files that include TB skin tests. Because TB skin tests are not required by NCIR, these rows are simply excluded from upload during the precheck sequence.
52: Historical vaccine. Some EMRs generate vaccine data files that include historical or legacy vaccine data entered into the EMR. “Historical” and “legacy” doses don’t necessarily imply that the doses were given a long time ago. “Historical” or “legacy vaccines” means that a facility besides your practice gave a dose of vaccine – for example, a hospital birth dose of hepatitis B vaccine. Historical vaccine upload is not supported at this time, so these vaccines are excluded from the upload during the precheck process.
Codes between 70-89 indicate a possible error in vaccine administration or documentation.
Codes 70, 76, 77, 78, and 79
70: Wrong flu vaccine for age. This is flagged during the precheck sequence when the Webdriver sees that, for example, a patient over 3 years of age received a vaccine indicated for ages 6-35 months. This might reflect that the wrong type of flu vaccine was given. Alternatively, the correct presentation may have been given, but the wrong presentation was documented. Recommended solution: check the patient’s chart in your EMR to see what was actually given.
76: Missing vaccine site. The Webdriver expects a site (in the sense of “body part”) for vaccination for each vaccine given, such as “Left Thigh” or “RA.” If this field is blank, the Webdriver gives dispo code 76. Recommended solution: update the patient’s chart in your EMR, then create an updated vaccine upload file.
•Alternatively, if a site is given but the Webdriver doesn’t know what the site means or maps to (e.g. “RtUE”), it will give this error. Recommended solution: configure your EMR to use the official HL7 body part mapping (https://www.hl7.org/fhir/v2/0163/index.html). If this is not possible, we can add a new mapping to the next build of the Webdriver.
77A and 77B: Mismatched fund source. This alert occurs if there appears to be a mismatch between the child’s VFC eligibility and what was actually given. For example, a child who is listed as being “VFC eligible” but receives a dose in a lot labeled “Private funds” will be tagged with dispo code 77A. Similarly, a child who is listed as being “Not VFC eligible” but receives vaccines with a lot entitled “Federal Funds” will receive a dispo code of 77B. Recommended solution: Be sure that the child’s insurance record is complete; a child who has commercial insurance (not VFC eligible) but does not have it entered in the record will appear self-pay (VFC eligible).
•NOTE: The Webdriver’s logic on VFC eligibility for practices is based on what is listed in the child’s primary and secondary insurance records; it assumes that you will always give VFC vaccine to any child who is VFC eligible. Practices who opt to give private stock vaccine to a child who has primary commercial insurance and secondary Medicaid will see this alert, even though this is technically an acceptable choice according to the VFC program.
78: Missing lot number. There is no lot number in your immunization file, so NCIR won’t accept the vaccine record. Recommended solution: enter the correct lot number in the EMR record, paste this lot number into the output spreadsheet, then re-run the output spreadsheet.
79: Name parse error (PCC only). PCC reports patient names in its immunization input file as Last, First MI. The comma splits the last and first name. If a name has multiple commas, such as “Berman, Jr, Robert” or “Heusen, Paul, ‘Bono’” the algorithm is confused. Recommended solution: remove commas from first and last names and use suffix or alternate name fields instead.
Codes 82, 84, 86, 87, 88, and 89
Codes in this group refer to VFC-related errors.
82: “Local specific” VFC eligibility (PCC only.) The vaccine administrator documented the VFC eligibility code in PCC as “local specific,” which is not an NCIR-recognized VFC eligibility code.
86: Not VFC, but should be (PCC only). The vaccinator chose a non-VFC status, but the child’s age and insurance suggest that he/she is VFC eligible.
87: Shouldn’t be VFC based on age/insurance (PCC only). The vaccinator assigned a VFC status, but the patient has a commercial insurance and/or was over the age of 18 on the date of the vaccine.
88: VFC status is blank (PCC only.) The vaccine administrator did not select a VFC status in PCC.
89: VFC status is unexpected (PCC only). The vaccine administrator selected an unusual VFC eligibility status such as “Medicare,” which is not a separate VFC eligibility code that NCIR recognizes.
Upload disposition codes
The following dispositions occur during the upload phase.
“Success” codes: 1 and 3A
1: Already present in NCIR, as expected. This vaccine record is already present in NCIR, with an exact match on vaccine date and CVX code. A vaccine record may already be present in NCIR if, for example, a nurse entered the vaccine in NCIR right after administering it so a form could be printed.
3A: Successfully added as administered vaccine. The vaccine record was not present in NCIR, so the Webdriver tried to add it and was successful.
“Qualified success” codes: 2A and 2B
2: Already present in NCIR, with a different CVX code than expected. Each vaccine has a specific CVX code. There are also nonspecific CVX codes to identify a vaccine family if the exact vaccine type was not known. For example, HPV2 (Cervarix) has CVX code 118, HPV4 (Gardasil) has CVX code 62, and HPV9 (Gardasil-9) has CVX 165. The CVX code 137 (“HPV, unspecified formulation”) would be used to record a historical HPV vaccine where the exact type was unknown.
2A: NCIR lists the vaccine for that date, but with a nonspecific CVX code. A practice administering vaccines should know the exact formulation it is using. However, someone has already entered that vaccine as a nonspecific formulation on that same date. This almost always reflects an error in the existing NCIR entry. For example, let’s say you are running the Webdriver on a set of vaccines your practice gave several months ago, to make sure they were all entered in NCIR. While trying to enter a Gardasil-9 (CVX code 165) for patient Mario Gonzalez on 5/16/17, the Webdriver identifies that Mario’s NCIR record already contains an entry for nonspecific HPV (CVX 137) on the same day, administered by your office. Recommended solution: manually delete the existing NCIR entry and re-run the Webdriver so that a record with the correct CVX entry can be made.
2B: NCIR lists the vaccine for that date, but with a different specific CVX code. In the same scenario, the Webdriver identifies that Mario’s NCIR record already contains an entry for HPV4 (CVX code 62) on 5/16/17. A 2B disposition might reflect an error in how the vaccine was entered previously. It might also reflect that the existing entry is correct, i.e. Mario really did get HPV4 on 5/16/17, and not HPV9 as you are trying to enter now. This happens if your immunization records in your EMR are not associated with the correct CVX codes.
“Re-run” codes: NaN and 3
NaN: Not yet processed. The Webdriver didn’t get a chance to upload this record to NCIR yet. This is usually because an error occurred, causing the Webdriver to stop running the script. If you check the “Rerun/continue the Output file” box then click Upload vaccines, the program will start where it left off in the output file, rather than starting with the input file all over again). If you rerun the output file multiple times and still only get NaNs, this suggests a configuration problem or Internet connection problem.
3: Processed, but unable to be entered in NCIR. The Webdriver identified this vaccine as needing to be entered, but it was unable to do so. Most commonly, this occurs when a child receives multiple vaccines on a day, and none of the vaccines could be entered because of a problem with one of the vaccines. The “problem” vaccine will receive a specific error code, such as 000; the other vaccines will receive disposition codes of 3. On subsequent passes of the Webdriver, the program will try to enter the remaining vaccines that contain 3.
A vaccine record that’s perpetually a 3 after multiple passes suggests an undiagnosed/undifferentiated error in the Webdriver program and should be reported. It sometimes also exists if there are multiple “stacked” errors for vaccines for a single patient.
“Error” codes: 000, 7A, 5, 5A, 99, 6A and 6B
000: There is no such lot active with that name, in that particular stock (VFC or private). This sometimes happens when nursing staff begin administering a new vaccine lot without first activating it in NCIR. The solution here is to log into NCIR and activate or create the appropriate lots, then rerun the 000 codes. An alternate cause for the error is when lot names are similar, but not identical, in NCIR and your EMR. A lot called “ABC123-1” in your EMR does not match a lot called “ABC123” in NCIR. A lot called “DEF456 ” (trailing space) will not find an exact match in an NCIR lot called “DEF456” no space. Changing the lot name in the EMR or NCIR so that they match exactly will solve the problem.
7A: Overlapping antigen alert/error. The Webdriver found a vaccine that was not present in the patient’s record and attempted to enter it, but NCIR gave an “overlapping antigen” alert. The Webdriver cancelled its attempt to enter the vaccine. This alert occurs when two identical or very similar vaccines were given closer together than anticipated. For example, if the Webdriver is trying to enter a Tdap for Mario on 12/16/17, it will throw an “overlapping antigen” alert if there is already a Tdap entered on 12/14/17. While it’s clinically possible that Mario got a Tdap at another facility 2 days before you gave him one on 12/16, a date error is more likely. This often happens when nurses give a vaccine on one day but don’t chart it until a day or two later — then forget to backdate their work to the correct date of administration. Recommended solution: review the chart to see what date the child actually received the vaccine(s) in question.
5: The patient couldn’t be selected from among the various possible patients in NCIR. Let’s say the Webdriver tries to find the NCIR record for John Smith-Wesson, DOB 10/6/2016, but the two closest matches that NCIR suggests are John Smith, DOB 10/6/2016 and Jack Smith-Wesson, DOB 10/6/2016. The Webdriver sees that these two possibilities match the existing information on two out of three fields, but neither is a perfect match. Because the Webdriver can’t find a perfect match, it skips this patient and does not attempt to enter any of the vaccines. Recommended solution: add your practice’s EMR chart number to the correct record in NCIR, then re-run the disposition 5s.
5A: There was more than one perfect match in NCIR. Similar to dispo code 5. In the above example, when trying to search for this patient, there are two NCIR records with John Smith-Wesson, DOB 10/6/2016. Because they are both perfect matches, the Webdriver can’t tell which one should receive the new vaccine entries, and it moves on to the next patient. This error usually reflects two NCIR records for the same person. Recommended solution: inactivate one record in NCIR if one is a duplicate, or add your practice’s EMR chart number to the correct record.
99: No patient with this name or DOB found in NCIR. NCIR has no suggestions for this patient’s name or DOB. Recommended solution: update the child’s name in NCIR (e.g. to reflect an adoptive name change) or create a new patient record in NCIR (e.g. for a patient who has moved from out of state.)
6A: The ordering provider in your EMR’s file can’t be found in your NCIR account. This occurs when the ordering provider in your EMR is not found in your Staff table, and/or the crosswalk to the provider’s name in NCIR does not exactly match that provider’s record in NCIR. See the section Editing your Staff file for more information on how to fix this error.
6B: The vaccine giver can’t be found in your NCIR account. Like 6A, with similar causes and fixes.