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The CPT® Code 90750 refers to the Zoster (shingles) vaccine, specifically a recombinant, subunit, adjuvanted formulation intended for intramuscular use. This vaccine is designed to provide active, long-term immunity against the herpes zoster virus, which is responsible for shingles. Unlike immune globulins that offer short-term, passive immunity, vaccines stimulate the recipient's immune system to recognize and combat specific pathogens. The herpes zoster vaccine contains a recombinant version of the varicella zoster virus glycoprotein E (gE), which is enhanced with a proprietary adjuvant system. This adjuvant is crucial as it amplifies the immune response to the glycoprotein, thereby increasing the effectiveness of the vaccine in preventing the reactivation of the latent virus. When the varicella zoster virus reactivates, it can lead to shingles, characterized by a painful, dermatomal rash consisting of small vesicles. In some cases, this condition can result in chronic neuropathic pain even after the rash has healed, highlighting the importance of vaccination in preventing such complications.
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The Zoster (shingles) vaccine is indicated for the prevention of herpes zoster, commonly known as shingles. This vaccine is particularly recommended for individuals who are at risk of reactivation of the varicella zoster virus, which can lead to the development of shingles. The vaccine is intended to reduce the incidence of shingles and its associated complications, including the painful rash and potential chronic neuropathic pain that may follow the resolution of the rash.
The administration of the Zoster vaccine involves several key procedural steps to ensure proper delivery and effectiveness of the vaccine. First, the healthcare provider will prepare the vaccine for intramuscular injection, ensuring that it is stored and handled according to the manufacturer's guidelines. This includes checking the vaccine for any particulate matter or discoloration before use. Next, the provider will select an appropriate injection site, typically the deltoid muscle of the upper arm, which is commonly used for intramuscular vaccinations. The skin over the injection site will be cleaned with an antiseptic wipe to reduce the risk of infection. Following this, the vaccine will be drawn into a syringe, and the provider will administer the injection at a 90-degree angle to ensure proper delivery into the muscle tissue. After the injection, the site may be gently massaged to facilitate absorption, and the patient will be monitored for any immediate adverse reactions. Finally, appropriate documentation of the vaccine administration, including the date, lot number, and site of injection, will be recorded in the patient's medical record.
After the administration of the Zoster vaccine, patients are typically advised to remain in the healthcare setting for a short period to monitor for any immediate adverse reactions, such as allergic responses. Common post-procedure care includes advising the patient to apply a cool compress to the injection site if they experience pain or swelling. Patients may also be informed about potential side effects, which can include mild soreness at the injection site, low-grade fever, or fatigue. It is important for patients to be educated on the signs of more serious reactions, such as difficulty breathing or swelling of the face and throat, and to seek immediate medical attention if these occur. Additionally, patients should be encouraged to keep the injection site clean and dry and to avoid strenuous activities that may irritate the area for a short period following the vaccination. Follow-up appointments may be scheduled to assess the patient's response to the vaccine and to provide any necessary additional doses if indicated.
| Short Descr | HZV VACC RECOMBINANT IM | Medium Descr | HZV ZOSTER VACC RECOMBINANT ADJUVANTED IM NJX | Long Descr | Zoster (shingles) vaccine (HZV), recombinant, subunit, adjuvanted, 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 Not Billable to the MAC | Type of Service (TOS) | 1 - Medical Care | Berenson-Eggers TOS (BETOS) | none | MUE | 1 |
| 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 | GA | Waiver of liability statement issued as required by payer policy, individual case | GC | This service has been performed in part by a resident under the direction of a teaching physician | GZ | Item or service expected to be denied as not reasonable and necessary | JZ | Zero drug amount discarded/not administered to any patient | SL | State supplied vaccine | GX | Notice of liability issued, voluntary under payer policy | 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. | UD | Medicaid level of care 13, 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 | TR | School-based individualized education program (iep) services provided outside the public school district responsible for the student | 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. | 51 | Multiple procedures: when multiple procedures, other than e/m services, physical medicine and rehabilitation services or provision of supplies (eg, vaccines), are performed at the same session by the same individual, the primary procedure or service may be reported as listed. the additional procedure(s) or service(s) may be identified by appending modifier 51 to the additional procedure or service code(s). note: this modifier should not be appended to designated "add-on" codes (see appendix d). | 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. | AQ | Physician providing a service in an unlisted health professional shortage area (hpsa) | CC | Procedure code change (use 'cc' when the procedure code submitted was changed either for administrative reasons or because an incorrect code was filed) | CG | Policy criteria applied | EP | Service provided as part of medicaid early periodic screening diagnosis and treatment (epsdt) program | 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 | HX | Funded by county/local agency | JG | Drug or biological acquired with 340b drug pricing program discount, reported for informational purposes | KX | Requirements specified in the medical policy have been met | LT | Left side (used to identify procedures performed on the left side of the body) | MA | Ordering professional is not required to consult a clinical decision support mechanism due to service being rendered to a patient with a suspected or confirmed emergency medical condition | 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 | PN | Non-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 | Q5 | Service furnished under a reciprocal billing 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 | 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) | SA | Nurse practitioner rendering service in collaboration with a physician | SK | Member of high risk population (use only with codes for immunization) | TB | Drug or biological acquired with 340b drug pricing program discount, reported for informational purposes | U1 | Medicaid level of care 1, as defined by each state | U6 | Medicaid level of care 6, as defined by each state | U7 | Medicaid level of care 7, as defined by each state | UC | Medicaid level of care 12, as defined by each state | XS | Separate structure, a service that is distinct because it was performed on a separate organ/structure | 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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| 2019-01-01 | Changed | First appearance of FDA approval change in code book |
| 2018-01-01 | Added | First appearance in code book |
| 2018-01-01 | Changed | Code description changed. |
| 2017-10-07 | Changed | Product granted FDA approval. |
| 2017-01-01 | Added | Code added. |
| 1991-12-31 | Deleted | Code deleted. |
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