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The Bacillus Calmette-Guerin vaccine (BCG) is a live vaccine specifically designed for intravesical use in the treatment of bladder cancer. Unlike immune globulins, which provide short-term, passive immunity, vaccines like BCG offer active, long-term immunity. This is achieved by exposing the recipient's immune system to altered versions of specific bacteria, prompting the immune system to produce its own antibodies against the invading microorganisms. The BCG vaccine is derived from a live, weakened strain of Mycobacterium bovis, which is the bacterium responsible for bovine tuberculosis. This strain is attenuated through a prolonged culturing process in a controlled artificial medium, rendering it nonvirulent to humans. While the primary use of the BCG vaccine is for the prevention of tuberculosis, it has also been found effective in treating bladder cancer, although the precise mechanisms by which it combats cancer are not fully understood. It is important to note that CPT® Code 90585 is designated for the live BCG vaccine used for percutaneous injection against tuberculosis, whereas CPT® Code 90586 is specifically used when the vaccine is instilled through a catheter into the bladder for the treatment of bladder cancer. Both codes serve to report the product (vaccine) utilized in these procedures.
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The Bacillus Calmette-Guerin vaccine (BCG) is indicated for the treatment of bladder cancer. It is specifically utilized in patients diagnosed with superficial bladder cancer, particularly those with carcinoma in situ or recurrent transitional cell carcinoma. The vaccine is administered intravesically, meaning it is instilled directly into the bladder through a catheter, to stimulate the immune response against cancerous cells.
The procedure for administering the Bacillus Calmette-Guerin vaccine (BCG) involves several key steps to ensure proper delivery and effectiveness. First, the patient is positioned comfortably, and a sterile catheter is prepared for insertion. The healthcare provider will then clean the urethral area to minimize the risk of infection. Following this, the catheter is gently inserted into the bladder through the urethra. Once the catheter is in place, the BCG vaccine is drawn into a syringe and instilled through the catheter into the bladder. The patient is typically instructed to retain the vaccine in the bladder for a specified duration, usually around two hours, to allow for optimal absorption and immune response activation. After the retention period, the patient may void the bladder to expel the vaccine. It is crucial that the procedure is performed in a sterile environment to prevent any complications or infections.
After the administration of the Bacillus Calmette-Guerin vaccine, patients may experience some mild side effects, including urinary frequency, urgency, and mild discomfort. It is important for patients to stay well-hydrated and to report any severe or persistent symptoms to their healthcare provider. Follow-up appointments are typically scheduled to monitor the patient's response to the treatment and to assess for any potential complications. Regular cystoscopic evaluations may also be performed to check for the presence of cancerous cells in the bladder following the treatment.
| Short Descr | BCG VACCINE INTRAVESICAL | Medium Descr | BACILLUS CALMETTE-GUERIN VACCINE INTRAVESICAL | Long Descr | Bacillus Calmette-Guerin vaccine (BCG) for bladder cancer, live, for intravesical use | Related Drugs | TICE BCG | Status Code | Excluded from Physician Fee Schedule by Regulation | Global Days | XXX - Global Concept Does Not Apply | PC/TC Indicator (26, TC) | 9 - Not Applicable | Multiple Procedures (51) | 9 - Concept does not apply. | Bilateral Surgery (50) | 9 - Concept does not apply. | Physician Supervisions | 09 - Concept does not apply. | Assistant Surgeon (80, 82) | 9 - Concept does not apply. | Co-Surgeons (62) | 9 - Concept does not apply. | Team Surgery (66) | 9 - Concept does not apply. | Diagnostic Imaging Family | 99 - Concept Does Not Apply | APC Status Indicator | Code Not Recognized by OPPS when submitted on Outpatient Hospital Part B Bill Type (12x/13x) | Type of Service (TOS) | 1 - Medical Care | Berenson-Eggers TOS (BETOS) | O1D - Chemotherapy | MUE | 1 | CCS Clinical Classification | 228 - Prophylactic vaccinations and inoculations |
| 59 | Distinct procedural service: under certain circumstances, it may be necessary to indicate that a procedure or service was distinct or independent from other non-e/m services performed on the same day. modifier 59 is used to identify procedures/services, other than e/m services, that are not normally reported together, but are appropriate under the circumstances. documentation must support a different session, different procedure or surgery, different site or organ system, separate incision/excision, separate lesion, or separate injury (or area of injury in extensive injuries) not ordinarily encountered or performed on the same day by the same individual. however, when another already established modifier is appropriate it should be used rather than modifier 59. only if no more descriptive modifier is available, and the use of modifier 59 best explains the circumstances, should modifier 59 be used. note: modifier 59 should not be appended to an e/m service. to report a separate and distinct e/m service with a non-e/m service performed on the same date, see modifier 25. | JZ | Zero drug amount discarded/not administered to any patient | Q1 | Routine clinical service provided in a clinical research study that is in an approved clinical research study |
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| 2011-01-01 | Changed | Short description changed. |
| 1999-01-01 | Added | First appearance in code book in 1999. |
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