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The CPT® Code 90746 refers to the Hepatitis B vaccine (HepB) specifically formulated for adult patients, administered in a three-dose schedule via intramuscular injection. 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 the 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 B vaccine is crucial in preventing chronic liver disease, which can lead to severe health complications, including hospitalization and death. Additionally, it plays a significant role in reducing the risk of long-term consequences such as hepatocellular carcinoma, marking it as one of the pioneering cancer vaccines in medical use. The vaccine can be derived from the blood plasma of asymptomatic carriers or synthesized 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 for use. It is important to note that the codes associated with the hepatitis B vaccine, including CPT® Code 90746, specifically report the vaccine product for intramuscular use, while the actual injection procedure is reported separately. Other related codes include 90739 for a 2-dose or 4-dose schedule of CpG-adjuvanted HepB vaccine, 90740 for dialysis or immunosuppressed patients in a 3-dose schedule, 90743 for an adolescent 2-dose schedule, and 90744 for a pediatric/adolescent 3-dose schedule. Additionally, CPT® Code 90747 is designated for dosage in dialysis or immunosuppressed patients following a 4-dose schedule.
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The Hepatitis B vaccine (HepB) is indicated for the prevention of hepatitis B virus infection in adults. This vaccine is particularly important for individuals who are at risk of exposure to the virus, which can lead to chronic liver disease, hospitalization, and even death. The vaccine is also recommended for those who may be at risk of developing long-term complications associated with hepatitis B, such as hepatocellular carcinoma.
The administration of the Hepatitis B vaccine (CPT® Code 90746) follows a structured three-dose schedule. Each dose is given intramuscularly, typically in the deltoid muscle of the upper arm. The procedure is as follows:
After the administration of the Hepatitis B vaccine, patients are usually monitored for a short period to observe for any immediate adverse reactions, such as allergic responses. Common side effects may include soreness at the injection site, mild fever, or fatigue, which typically resolve on their own. Patients are advised to report any unusual or severe reactions to their healthcare provider. It is also important for patients to complete the entire three-dose series to ensure optimal immunity against hepatitis B. Follow-up appointments should be scheduled to administer the subsequent doses as recommended.
| Short Descr | HEPB VACCINE 3 DOSE ADULT IM | Medium Descr | HEPB VACCINE ADULT 3 DOSE SCHEDULE FOR IM USE | Long Descr | Hepatitis B vaccine (HepB), adult dosage, 3 dose schedule, for intramuscular use | Related Drugs | ENGERIX-B | Status Code | Statutory Exclusion (from MPFS, may be paid under other methodologies) | 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 | Influenza, Pneumococcal Pneumonia, Hepatitis B, and Covid-19 Vaccines; Monoclonal Antibody Therapy Product | ASC Payment Indicator | Corneal tissue acquisition, hepatitis B vaccine; paid at reasonable cost. | Type of Service (TOS) | 1 - Medical Care | Berenson-Eggers TOS (BETOS) | O1G - Immunizations/Vaccinations | MUE | 1 | CCS Clinical Classification | 228 - Prophylactic vaccinations and inoculations |
| GA | Waiver of liability statement issued as required by payer policy, individual case | 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 | CR | Catastrophe/disaster related | 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. | 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 | GC | This service has been performed in part by a resident under the direction of a teaching physician | U6 | Medicaid level of care 6, as defined by each state | CC | Procedure code change (use 'cc' when the procedure code submitted was changed either for administrative reasons or because an incorrect code was filed) | 25 | Significant, separately identifiable evaluation and management service by the same physician or other qualified health care professional on the same day of the procedure or other service: it may be necessary to indicate that on the day a procedure or service identified by a cpt code was performed, the patient's condition required a significant, separately identifiable e/m service above and beyond the other service provided or beyond the usual preoperative and postoperative care associated with the procedure that was performed. a significant, separately identifiable e/m service is defined or substantiated by documentation that satisfies the relevant criteria for the respective e/m service to be reported (see evaluation and management services guidelines for instructions on determining level of e/m service). the e/m service may be prompted by the symptom or condition for which the procedure and/or service was provided. as such, different diagnoses are not required for reporting of the e/m services on the same date. this circumstance may be reported by adding modifier 25 to the appropriate level of e/m service. note: this modifier is not used to report an e/m service that resulted in a decision to perform surgery. see modifier 57 for significant, separately identifiable non-e/m services, see modifier 59. | 76 | Repeat procedure or service by same physician or other qualified health care professional: it may be necessary to indicate that a procedure or service was repeated by the same physician or other qualified health care professional subsequent to the original procedure or service. this circumstance may be reported by adding modifier 76 to the repeated procedure or service. note: this modifier should not be appended to an e/m service. | AQ | Physician providing a service in an unlisted health professional shortage area (hpsa) | GV | Attending physician not employed or paid under arrangement by the patient's hospice provider | 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 | JG | Drug or biological acquired with 340b drug pricing program discount, reported for informational purposes | LT | Left side (used to identify procedures performed on the left side of the body) | PD | Diagnostic or related non diagnostic item or service provided in a wholly owned or operated entity to a patient who is admitted as an inpatient within 3 days | PO | Excepted service provided at an off-campus, outpatient, provider-based department of a hospital | Q1 | Routine clinical service provided in a clinical research study that is in an approved clinical research study | Q6 | Service furnished under a fee-for-time compensation arrangement by a substitute physician or by a substitute physical therapist furnishing outpatient physical therapy services in a health professional shortage area, a medically underserved area, or a rural area | RT | Right side (used to identify procedures performed on the right side of the body) | SK | Member of high risk population (use only with codes for immunization) | SL | State supplied vaccine | TB | Drug or biological acquired with 340b drug pricing program discount, reported for informational purposes | UA | Medicaid level of care 10, as defined by each state | UC | Medicaid level of care 12, as defined by each state | UD | Medicaid level of care 13, as defined by each state | X3 | Episodic/broad services: for reporting services by clinicians who have broad responsibility for the comprehensive needs of the patient that is limited to a defined period and circumstance such as a hospitalization; reporting clinician service examples include but are not limited to the hospitalist's services rendered providing comprehensive and general care to a patient while admitted to the hospital | XE | Separate encounter, a service that is distinct because it occurred during a separate encounter | XU | Unusual non-overlapping service, the use of a service that is distinct because it does not overlap usual components of the main service |
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Notes
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| 2016-01-01 | Changed | First appearance of change in codebook. |
| 2015-07-01 | Changed | Description Changed |
| 2013-01-01 | Changed | Description Changed |
| 2011-01-01 | Changed | Short description changed. |
| 1996-01-01 | Added | First appearance in code book in 1996. |
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