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Coding guidelines for Hepatitis B vaccine

CDC – Childhood Immunization Schedule – Hepatitis B vaccine

Hepatitis B vaccine (HepB). (Minimum age: birth)

At birth:

• Administer monovalent HepB to all newborns prior to hospital discharge.

• If mother is hepatitis B surface antigen (HBsAg)-positive, administer HepB and 0.5 mL of hepatitis B immune globulin (HBIG) within 12 hours of birth.

• If mother’s HBsAg status is unknown, administer HepB within 12 hours of birth. Determine the HBsAg status as soon as possible and if HBsAg-positive, administer HBIG (no later than age 1 week).

• If mother is HBsAg-negative, the birth dose can be delayed, in rare cases, with a provider’s order and a copy of the mother’s negative HBsAg laboratory report in the infant’s medical record.

After the birth dose:

• The HepB series should be completed with either monovalent HepB or a combination vaccine containing HepB. The second dose should be administered at age 1–2 months. The final dose should be administered no earlier than age 24 weeks. Infants born to HBsAg-positive mothers should be tested for HBsAg and antibody to HBsAg after completion of at least 3 doses of a licensed HepB series, at age 9–18 months (generally at the next well-child visit).

4-month dose:

• It is permissible to administer 4 doses of HepB when combination vaccines are administered after the birth dose. If monovalent HepB is used for doses after the birth dose, a dose at age 4 months is not needed.

Coding information:

CPT: Report CPT 90740 for a 3-dose schedule for a dialysis or immunosuppressed patient; CPT 90743 for an adolescent 2-dose schedule; CPT 90744 for a pediatric/adolescent 3-dose schedule; CPT 90746 for an adult dosage; and CPT 90747 for a 4-dose schedule for a dialysis or immunosuppressed patient.

Report any of the above applicable vaccine codes with the administration code CPT 90465 or CPT 90466 (if the vaccine is administered in addition to anyother vaccine).
For CPT 90746 please report CPT 90471 / 90472 as its administration code.

ICD: V05.3 or V20.2 (if the vaccines are reported along with Preventive examination)

Reference: http://www.cdc.gov/vaccines/pubs/vis/downloads/vis-hep-b.pdf

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