How To Use CPT Code 90759

CPT code 90759 describes the administration of a three-antigen hepatitis B vaccine, given intramuscularly in a three-dose schedule. This article will cover the description, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information, similar codes and billing examples.

1. What is CPT Code 90759?

CPT 90759 represents the administration of a vaccine that protects against the hepatitis B virus. This vaccine contains three surface antigens, which mimic the naturally occurring particles of the virus. By introducing these antigens into the body, the vaccine stimulates the production of antibodies, providing long-term protection against hepatitis B.

2. Official Description

The official description of CPT code 90759 is: ‘Hepatitis B vaccine (HepB), 3-antigen (S, Pre-S1, Pre-S2), 10 mcg dosage, 3 dose schedule, for intramuscular use.’

3. Procedure

1. The healthcare provider administers the hepatitis B vaccine intramuscularly.
2. The vaccine contains three surface antigens (S, Pre-S1, Pre-S2) that resemble the hepatitis B virus particles.
3. The vaccine is given in a three-dose schedule, with each dose typically administered weeks or months apart.
4. The dosage of the vaccine is 10 mcg.
5. The administration of the vaccine helps reduce the patient’s risk of contracting hepatitis B.

4. Qualifying circumstances

CPT 90759 is used for patients who are at risk of contracting hepatitis B and require vaccination. This may include individuals with occupational exposure to blood or other body fluids, individuals with multiple sexual partners, individuals with chronic liver disease, and newborns of hepatitis B-positive mothers. The vaccine is administered by a healthcare provider, and the route of administration is intramuscular.

5. When to use CPT code 90759

CPT code 90759 should be used when administering the three-antigen hepatitis B vaccine to eligible patients. It is important to ensure that the vaccine is administered intramuscularly and that the appropriate dosage and schedule are followed. This code should not be used for other vaccines or for different dosages or schedules of the hepatitis B vaccine.

6. Documentation requirements

To support a claim for CPT 90759, the healthcare provider must document the following information:

• Patient’s eligibility for the hepatitis B vaccine
• Date of administration
• Route of administration (intramuscular)
• Dosage of the vaccine (10 mcg)
• Number of doses administered and the schedule followed
• Signature of the healthcare provider administering the vaccine

7. Billing guidelines

When billing for CPT 90759, ensure that the vaccine is administered intramuscularly and that the appropriate dosage and schedule are followed. It is important to report a separate code for vaccine administration. CPT code 90759 should not be reported with other vaccine codes unless the patient receives additional vaccines during the same encounter. It is also important to follow any specific billing guidelines provided by the payer.

8. Historical information

CPT code 90759 was added to the Current Procedural Terminology system on July 1, 2022. There have been no updates or changes to the code since its addition.

9. Examples

1. A healthcare provider administers the three-antigen hepatitis B vaccine to a newborn of a hepatitis B-positive mother.
2. A nurse administers the three-antigen hepatitis B vaccine to a healthcare worker with occupational exposure to blood and body fluids.
3. A physician administers the three-antigen hepatitis B vaccine to a patient with chronic liver disease.
4. A healthcare provider administers the three-antigen hepatitis B vaccine to an individual with multiple sexual partners.
5. A nurse administers the three-antigen hepatitis B vaccine to a patient undergoing dialysis.
6. A healthcare provider administers the three-antigen hepatitis B vaccine to a patient receiving immunosuppressive therapy.
7. A physician administers the three-antigen hepatitis B vaccine to a patient who is planning to travel to a region with a high prevalence of hepatitis B.
8. A nurse administers the three-antigen hepatitis B vaccine to a patient who is starting a new job in a healthcare setting.
9. A healthcare provider administers the three-antigen hepatitis B vaccine to a patient with a history of intravenous drug use.
10. A nurse administers the three-antigen hepatitis B vaccine to a patient with a compromised immune system.