How To Use CPT Code 90620

CPT 90620 refers to the administration of a meningococcal recombinant protein and outer membrane vesicle vaccine, serogroup B (MenB-4C), as part of a two-dose schedule for intramuscular use. This article will cover the description, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information, similar codes, and examples of CPT 90620 procedures.

1. What is CPT 90620?

CPT 90620 is a medical billing code used to describe the administration of a meningococcal recombinant protein and outer membrane vesicle vaccine, serogroup B (MenB-4C). This vaccine is administered intramuscularly as part of a two-dose schedule to protect individuals from meningococcal diseases such as Neisseria meningitidis. The vaccine is recommended for individuals aged 10 years and older who are at risk for the disease.

2. 90620 CPT code description

The official description of CPT code 90620 is: “Meningococcal recombinant protein and outer membrane vesicle vaccine, serogroup B (MenB-4C), 2 dose schedule, for intramuscular use.”

3. Procedure

The 90620 CPT code procedure involves the following steps:

1. The patient is appropriately prepped for the vaccine administration.
2. The provider counsels the patient and/or their family about the risks, benefits, potential side effects, and precautions associated with the vaccine.
3. The provider injects the meningococcal recombinant protein and outer membrane vesicle vaccine, serogroup B (MenB-4C), into the muscle of the upper arm.
4. This is the first of a series of two doses necessary to protect the patient against meningococcal diseases.
5. The provider documents the vaccine administration, including the product used, administration route, and purpose.

4. Qualifying circumstances

Individuals eligible to receive CPT code 90620 services include those who are:

• Aged 10 years and older
• At risk for meningococcal diseases such as Neisseria meningitidis
• Recommended by their healthcare provider to receive the vaccine

It is important to note that the vaccine may not be suitable for everyone, and healthcare providers should assess each patient’s medical history and risk factors before administering the vaccine.

5. When to use CPT code 90620

It is appropriate to bill the 90620 CPT code when a healthcare provider administers the meningococcal recombinant protein and outer membrane vesicle vaccine, serogroup B (MenB-4C), as part of a two-dose schedule for intramuscular use. This code should be used for the first dose of the vaccine series.

6. Documentation requirements

To support a claim for CPT 90620, the following information should be documented:

• Patient’s age and risk factors for meningococcal diseases
• Provider’s recommendation for the vaccine
• Date and time of vaccine administration
• Product used, including the vaccine’s brand name and lot number
• Administration route (intramuscular)
• Purpose of the vaccine administration
• Any counseling provided to the patient and/or their family

7. Billing guidelines

When billing for CPT code 90620, it is important to follow these guidelines:

• Report separate codes for vaccine administration, the actual vaccine, and an office visit.
• Ensure sufficient documentation is provided to support the claim, including the product administered, administration route, and purpose.
• If the provider administers a recombinant lipoprotein vaccine for serogroup B meningococcal infection, use code 90621 instead of 90620.

8. Historical information

CPT 90620 was added to the Current Procedural Terminology system on January 1, 2016. The code was changed on January 1, 2017, with the previous descriptor being “Meningococcal recombinant protein and outer membrane vesicle vaccine, serogroup B (MenB), 2 dose schedule, for intramuscular use.”

9. Similar codes to CPT 90620

Five similar codes to CPT 90620 and how they differentiate are:

1. CPT 90621: This code is used for the administration of a recombinant lipoprotein vaccine for serogroup B meningococcal infection.
2. CPT 90619: This code is used for the administration of a meningococcal conjugate vaccine, serogroups A, C, W, and Y, for intramuscular use.
3. CPT 90644: This code is used for the administration of a meningococcal conjugate vaccine, serogroups C and Y, for intramuscular use.
4. CPT 90734: This code is used for the administration of a meningococcal conjugate vaccine, serogroups A, C, W, and Y, for individuals aged 11 through 55 years, for intramuscular use.
5. CPT 90733: This code is used for the administration of a meningococcal polysaccharide vaccine, serogroups A, C, W, and Y, for subcutaneous use.

10. Examples

Here are 10 detailed examples of CPT code 90620 procedures:

1. A 12-year-old patient with a family history of meningococcal disease receives the first dose of the MenB-4C vaccine.
2. A 15-year-old patient who will be traveling to a high-risk area for meningococcal disease receives the first dose of the MenB-4C vaccine.
3. An 18-year-old college student living in a dormitory receives the first dose of the MenB-4C vaccine as a preventive measure.
4. A 25-year-old patient with a compromised immune system receives the first dose of the MenB-4C vaccine.
5. A 30-year-old patient who works in a laboratory handling meningococcal bacteria receives the first dose of the MenB-4C vaccine.
6. A 45-year-old patient with an asplenia condition receives the first dose of the MenB-4C vaccine.
7. A 50-year-old patient who is a military recruit receives the first dose of the MenB-4C vaccine.
8. A 55-year-old patient who will be undergoing a splenectomy receives the first dose of the MenB-4C vaccine.
9. A 60-year-old patient with a history of meningococcal disease receives the first dose of the MenB-4C vaccine as a booster.
10. A 65-year-old patient who is traveling to a country with a meningococcal disease outbreak receives the first dose of the MenB-4C vaccine.