CPT codes and Payments for Hepatitis B Virus (HBV) Vaccine
Hepatitis B is a serious disease caused by the hepatitis B virus (HBV). The virus can affect people of all ages. Hepatitis B attacks the liver and can cause chronic (life-long) infection, resulting in cirrhosis (scarring) of the liver, liver cancer, liver failure, and death. The virus is found in the blood and body fluids of infected people and can be spread through sexual contact; the sharing of needles, other drug paraphernalia, and razors; tattoos or body piercing; from a mother to her infant during birth; and by living in a household with a chronically infected person. Hepatitis B can be prevented with the vaccine. Medicare provides coverage of the hepatitis B vaccine and its administration for certain beneficiaries at intermediate to high risk for HBV.
Dosage Information
Scheduled doses of the hepatitis B vaccine are required to provide complete protection to an individual.
Coverage information
Medicare provides coverage for the hepatitis B vaccine and its administration for beneficiaries at intermediate or high risk of contracting HBV. Medicare requires that the hepatitis B vaccine be administered under a physician’s order with supervision.
High-risk groups currently identified include:
• Individuals with End-Stage Renal Disease (ESRD),
• Individuals with hemophilia who received Factor VIII or IX concentrates,
• Clients of institutions for the developmentally disabled,
• Individuals who live in the same household as an HBV carrier,
• Homosexual men, and
• Illicit injectable drug users.
Intermediate risk groups currently identified include:
• Staff in institutions for the developmentally disabled, and
• Workers in health care professions who have frequent contact with blood or blood-derived body fluids during routine work.
HCPCS / CPT Codes for Hepatitis B Vaccine and Administration
90740 Hepatitis B vaccine, dialysis or immunosuppressed patient dosage (3 dose schedule), for intramuscular use
90743 Hepatitis B vaccine, adolescent (2 dose schedule), for intramuscular use
90744 Hepatitis B vaccine, pediatric/adolescent dosage (3 dose schedule), for intramuscular use
90746 Hepatitis B vaccine, adult dosage, for intramuscular use
90747 Hepatitis B vaccine, dialysis or immunosuppressed patient dosage (4 dose schedule), for intramuscular use
G0010 Administration of Hepatitis B vaccine
Diagnosis Code for Hepatitis B Vaccination
V05.3 Need for prophylactic vaccination and inoculation against single diseases; Viral hepatitis.
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