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The CPT® Code 90747 refers to the Hepatitis B vaccine (HepB) specifically designed for patients who are undergoing dialysis or are immunosuppressed. This vaccine is administered in a 4-dose schedule via intramuscular injection. Unlike immune globulins, which offer short-term, passive immunity, vaccines like HepB provide active, long-term immunity. This is achieved by exposing the recipient's immune system to altered forms of the hepatitis B virus, prompting the immune system to produce its own antibodies. Consequently, the body retains the ability to generate these antibodies upon subsequent exposure to the virus, thereby offering protection against hepatitis B, a chronic and potentially serious liver disease that can lead to hospitalization and even death. The hepatitis B vaccine is significant not only for its role in preventing the disease but also for its potential to avert long-term complications such as hepatocellular carcinoma, making it one of the pioneering cancer vaccines in clinical 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 code 90747 specifically reports the hepatitis B vaccine product for intramuscular use, while the actual injection procedure is reported separately. Other related codes include 90739 for adult dosage in a 2-dose or 4-dose schedule, 90740 for dialysis or immunosuppressed patients in a 3-dose schedule, 90743 for an adolescent 2-dose schedule, 90744 for pediatric/adolescent dosage in a 3-dose schedule, and 90746 for adult 3-dose schedule dosage.
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The Hepatitis B vaccine (CPT® Code 90747) is indicated for patients who are undergoing dialysis or are immunosuppressed. These patients are at a higher risk for hepatitis B infection due to their compromised immune systems, making vaccination essential for their protection against this serious liver disease.
The administration of the Hepatitis B vaccine (CPT® Code 90747) follows a structured procedure to ensure effective immunization. The vaccine is delivered intramuscularly, typically in the deltoid muscle of the upper arm. The 4-dose schedule is designed to provide optimal immune response and long-term protection against hepatitis B. The first dose is administered, followed by subsequent doses at specified intervals to enhance the immune response. Each dose is carefully documented to maintain accurate records of the vaccination schedule, which is crucial for patient follow-up and compliance with immunization guidelines.
After the administration of the Hepatitis B vaccine, patients may experience mild side effects such as soreness at the injection site, low-grade fever, or fatigue. These effects are generally short-lived and resolve without intervention. It is important for healthcare providers to monitor patients for any adverse reactions and provide guidance on managing common side effects. Patients should also be informed about the importance of completing the full vaccination series to ensure adequate protection against hepatitis B. Follow-up appointments should be scheduled to administer the remaining doses as per the 4-dose schedule, and patients should be encouraged to report any unusual symptoms or concerns following vaccination.
| Short Descr | HEPB VACC 4 DOSE IMMUNSUP IM | Medium Descr | HEPB VACCINE DIALYSIS/IMMUNSUP PAT 4 DOSE IM | Long Descr | Hepatitis B vaccine (HepB), dialysis or immunosuppressed patient dosage, 4 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 |
| 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. | GC | This service has been performed in part by a resident under the direction of a teaching physician | 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 |
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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 |
| 2011-01-01 | Changed | Short description changed. |
| 2001-01-01 | Changed | Code description changed. |
| 1996-01-01 | Added | First appearance in code book in 1996. |
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