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Medical Coding News Archives

New and Revised Vaccine Codes Added to 2018 CPT Code Book

January 25, 2018:

The American Medical Association (AMA) added and revised several vaccine CPT codes for its 2018 code book. While some codes were effective January 1 or July 1, 2017, they did not appear in the code book until January 2018. At the CPT and RBRVS 2018 Annual Symposium in Chicago on November 16, 2017, the association discussed these vaccine CPT codes and associated dosing as well as codes that are new with an effective date of January 1, 2018. These codes are for single-dose as well as multi-dose vaccines as illustrated below.

90587 Dengue vaccine, quadrivalent, live

    Route: Subcutaneous use

    Dosing: 3-dose schedule

The dengue vaccine code was effective July 1, 2017. The vaccine is pending approval by the United States Food and Drug Administration (FDA) and will be the first of its kind. Dengue is a virus carried by mosquitos that is often contracted in more tropical areas. It manifests itself in humans through symptoms exhibited up to a week after initial infection. Most symptoms are mild (such as headaches, nausea, vomiting, and rash) and resolve in a complete recovery within a week. However, sometimes the disease can become more severe with symptoms such as severe abdominal pain, difficulty breathing, and bleeding from the gums, nose, and/or stomach. At this point, immediate medical attention is warranted, especially if the patient visited a tropical area where the dengue virus is known to be prevalent.

90682 Influenza virus, vaccine, quadrivalent (RIV4), derived from recombinant DNA, hemagglutinin (HA) protein only, preservative and antibiotic free

    Route: Intramuscular use

    Dosing: Single dose

90750 Zoster (shingles) vaccine (HZV), recombinant, subunit, adjuvanted

    Route: Intramuscular use

    Dosing: 2-dose schedule

90756 Influenza virus vaccine, quadrivalent (ccIIV4), derived from cell cultures, subunit, antibiotic free, 0.5 mL dosage

    Route: Intramuscular use

    Dosing: Single dose

Codes 90682 (effective January 1, 2017) and 90756 (effective January 1, 2018) allow for the reporting of doses that are quadrivalent, with one derived from cell cultures and the other from recombinant DNA with hemagglutinin protein.

Code 90750, also effective January 1, 2017, describes the new zoster vaccine. If a patient has had chicken pox, the shingles virus is present and could cause symptoms. This vaccine protects against the manifestation of the shingles virus. This code, which can be used to describe the vaccine with the brand name of Shingrix®, was granted FDA approval status effective October 20, 2017. This approval was granted after the CPT book was published, so the FDA approval pending icon is still appended to this code in the CPT code book and will be removed for the 2019 edition.

In addition to these additions, the following vaccine codes with an effective date of July 1, 2017, have been revised for the 2018 code book:

90620 Meningococcal recombinant protein and outer membrane vesicle vaccine, serogroup B (MenB-4C)

    Route: Intramuscular use

    Dosing: 2-dose schedule

Code 90620 describes the injection of Bexsaro by Novartis, which is approved by the FDA for patients ages 10-25 years of age. The doses are administered one month apart. The approved abbreviation has been updated, prompting the revision to the description for this code.

90621 Meningococcal recombinant lipoprotein vaccine, serogroup B (MenB-FHbp)

    Route: Intramuscular use

    Dosing: 2- or 3-dose schedule

This code is reported for MenB-FHbp (Trumenba by Pfizer, Inc.), which had been available in only a 3-dose schedule. It now has a 2-dose schedule that can be administered for patients over the age of 10.

90651 Human papillomavirus vaccine types 6, 11, 16, 18, 31, 33, 45, 52, 58 nonvalent (9vHPV)

    Route: Intramuscular use

    Dosing: 2- or 3-dose schedule

The dosing for the 9vHPV vaccine now includes a 2-dose schedule as well as the already available 3-dose schedule. All other human papillomavirus vaccines are established with only a 3-dose schedule (90649 and 90650).

This article is one of more than a thousand included in Optum360’s Specialty Articles available as an add-on to a subscription to our online coding tools. The articles rely on information from experts in various specialties, are fully searchable, and include sources. For more information, go to https://www.optum360coding.com/Product/36102/.

CPT © 2017 American Medical Association. All rights reserved.


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