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The CPT® Code 90636 refers to the Hepatitis A and Hepatitis B vaccine (HepA-HepB) specifically formulated for adult dosage and intended for intramuscular administration. Vaccines, unlike immune globulins that offer short-term, passive immunity, are designed to provide active, long-term immunity. This is achieved by introducing altered versions of specific viruses or bacteria into the recipient's immune system, prompting it to produce its own antibodies against these pathogens. The immune system retains a memory of these antibodies, enabling a quicker and more effective response upon subsequent exposures to the same antigens. The Hepatitis A vaccine offers significant protection against severe liver diseases, which can lead to hospitalization or even death, while the Hepatitis B vaccine safeguards against serious health issues, including hepatocellular carcinoma. The vaccine can be derived from the blood plasma of asymptomatic carriers or produced through recombinant technology, where a plasmid containing the hepatitis gene is inserted into common baker's yeast. This yeast is then lysed, and the components are purified to create the vaccine. The codes associated with hepatitis vaccines for intramuscular use include specific codes for different dosages and schedules, with code 90636 designated for the adult dosage of the combined HepA-HepB vaccine.
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The Hepatitis A and Hepatitis B vaccine (HepA-HepB) is indicated for adults who require immunization against both hepatitis A and hepatitis B viruses. This vaccine is particularly recommended for individuals at increased risk of exposure to these viruses, including:
The administration of the Hepatitis A and Hepatitis B vaccine (HepA-HepB) involves several key procedural steps to ensure proper delivery and effectiveness of the vaccine:
Post-procedure care for the Hepatitis A and Hepatitis B vaccine includes advising the patient on potential side effects, which may include soreness at the injection site, mild fever, or fatigue. Patients should be informed that these symptoms are generally mild and resolve within a few days. It is also important to instruct patients to report any severe or unusual reactions, such as difficulty breathing or swelling of the face and throat, which may indicate an allergic reaction. Follow-up appointments may be necessary to complete the vaccination series if additional doses are required, depending on the specific vaccination schedule recommended for the individual patient.
| Short Descr | HEP A/HEP B VACC ADULT IM | Medium Descr | HEPATITIS A & B VACCINE HEPA-HEPB ADULT IM | Long Descr | Hepatitis A and hepatitis B vaccine (HepA-HepB), adult dosage, for intramuscular use | 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 | Items and Services Packaged into APC Rates | ASC Payment Indicator | Packaged service/item; no separate payment made. | Type of Service (TOS) | 1 - Medical Care | Berenson-Eggers TOS (BETOS) | P6C - Minor procedures - other (Medicare fee schedule) | MUE | 1 | CCS Clinical Classification | 228 - Prophylactic vaccinations and inoculations |
| GY | Item or service statutorily excluded, does not meet the definition of any medicare benefit or, for non-medicare insurers, is not a contract benefit | JZ | Zero drug amount discarded/not administered to any patient | GA | Waiver of liability statement issued as required by payer policy, individual case | 22 | Increased procedural services: when the work required to provide a service is substantially greater than typically required, it may be identified by adding modifier 22 to the usual procedure code. documentation must support the substantial additional work and the reason for the additional work (ie, increased intensity, time, technical difficulty of procedure, severity of patient's condition, physical and mental effort required). note: this modifier should not be appended to an e/m service. | 27 | Multiple outpatient hospital e/m encounters on the same date: for hospital outpatient reporting purposes, utilization of hospital resources related to separate and distinct e/m encounters performed in multiple outpatient hospital settings on the same date may be reported by adding modifier 27 to each appropriate level outpatient and/or emergency department e/m code(s). this modifier provides a means of reporting circumstances involving evaluation and management services provided by physician(s) in more than one (multiple) outpatient hospital setting(s) (eg, hospital emergency department, clinic). note: this modifier is not to be used for physician reporting of multiple e/m services performed by the same physician on the same date. for physician reporting of all outpatient evaluation and management services provided by the same physician on the same date and performed in multiple outpatient setting(s) (eg, hospital emergency department, clinic), see evaluation and management, emergency department, or preventive medicine services codes. | 58 | Staged or related procedure or service by the same physician or other qualified health care professional during the postoperative period: it may be necessary to indicate that the performance of a procedure or service during the postoperative period was: (a) planned or anticipated (staged); (b) more extensive than the original procedure; or (c) for therapy following a surgical procedure. this circumstance may be reported by adding modifier 58 to the staged or related procedure. note: for treatment of a problem that requires a return to the operating/procedure room (eg, unanticipated clinical condition), see modifier 78. | 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. | 95 | Synchronous telemedicine service rendered via a real-time interactive audio and video telecommunications system: synchronous telemedicine service is defined as a real-time interaction between a physician or other qualified health care professional and a patient who is located at a distant site from the physician or other qualified health care professional. the totality of the communication of information exchanged between the physician or other qualified health care professional and the patient during the course of the synchronous telemedicine service must be of an amount and nature that would be sufficient to meet the key components and/or requirements of the same service when rendered via a face-to-face interaction. modifier 95 may only be appended to the services listed in appendix p. appendix p is the list of cpt codes for services that are typically performed face-to-face, but may be rendered via a real-time (synchronous) interactive audio and video telecommunications system. | CR | Catastrophe/disaster related | GC | This service has been performed in part by a resident under the direction of a teaching physician | GW | Service not related to the hospice patient's terminal condition | GX | Notice of liability issued, voluntary under payer policy | GZ | Item or service expected to be denied as not reasonable and necessary | SA | Nurse practitioner rendering service in collaboration with a physician | SL | State supplied vaccine | TW | Back-up equipment | UA | Medicaid level of care 10, as defined by each state | X1 | Continuous/broad services: for reporting services by clinicians, who provide the principal care for a patient, with no planned endpoint of the relationship; services in this category represent comprehensive care, dealing with the entire scope of patient problems, either directly or in a care coordination role; reporting clinician service examples include, but are not limited to: primary care, and clinicians providing comprehensive care to patients in addition to specialty care |
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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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