Oncology & Hematology Coding Alert

Mark revisions, although these may not be major.

Vaccine codes are anticipated to frequently undergo changes as more recent strains are identified. There may be changes in the code descriptors and deletion of obsolete codes. In 2016, this section has 15 new, 50 revised and 19 deleted codes.

Remember, in CPT®, new codes are marked with a red dot • and revised codes with a blue triangle ▲. Additionally and more frequently in the last few years, as codes are revised or resequenced, several now appear out of numerical order. CPT® indicates a code as being out of order using the # symbol and a notation in red text where the code would logically appear. For example: Code 90625 is listed in the CPT® text out of numerical sequence. A notation instructs you to “See 90476-90749.” In this example, the note is not very helpful since it describes the entire vaccine code range. In case you are wondering though, 90625 can be found between 90723 and 90732. Lastly, a lightning bolt symbol , means the code is pending FDA approval.

Common Vaccines Have New Code Assignments In 2016

Although there are 50 new codes in the entire medicine section, below is an example of a revised vaccine CPT® code against a carcinogenic virus called Human Papillomavirus:

• 90651, Human Papillomavirus vaccine types 6, 11, 16, 18, 31, 33, 45, 52, 58, nonavalent (9vHPV), 3 dose schedule, for intramuscular use

Below are some of the new vaccine codes and the first two are awaiting FDA approval:

•  90697, Diphtheria, tetanus toxoids, acellular pertussis vaccine, inactivated poliovirus vaccine, Haemophilus influenzae type b PRP-OMP conjugate vaccine, and hepatitis B vaccine (DTaP-IPV-Hib-HepB), for intramuscular use
• 90625, Cholera vaccine, live, adult dosage, 1 dose schedule, for oral use (90727 has been deleted)
• 90620, Meningococcal recombinant protein and outer membrane vesicle vaccine, Serogroup B (MenB), 2 dose schedule, for intramuscular use
• 90621, Meningococcal recombinant lipoprotein vaccine, Serogroup B (MenB), 3 dose schedule, for intramuscular use (90735 has been deleted)

Revised Codes Reflect Minimal Changes

Most of the revised codes have minimal changes, such as adding an abbreviation like (HepA) for hepatitis A, (Hib) for Haemophilus influenzae type b, (IIV) for inactivated, (II3V) for trivalent or (IIV4) for quadrivalent in in the code descriptor. They are:

▲ 90632 Hepatitis A vaccine (HepA), adult dosage, for intramuscular use

▲90647 Haemophilus influenzae type b vaccine (Hib), PRP-OMP conjugate, 3 dose schedule, for intramuscular use

▲ 90653 Influenza vaccine, inactivated (IIV), subunit, adjuvanted, for intramuscular use

▲ 90655 Influenza virus vaccine, trivalent (IIV3), split virus, preservative free, when administered to children 6-35 months of age, for intramuscular use

# 90630 Influenza virus vaccine, quadrivalent (IIV4), split virus, preservative free, for intradermal use.