CPT® Code 90759

1. Indications

The hepatitis B vaccine (HepB) is indicated for individuals who require protection against hepatitis B virus infection. The following conditions and circumstances warrant the administration of this vaccine:

• High-Risk Populations Individuals who are at increased risk of exposure to hepatitis B, such as healthcare workers, individuals with multiple sexual partners, and those who inject drugs.
• Chronic Liver Disease Patients with chronic liver conditions who may be more susceptible to the effects of hepatitis B infection.
• Travelers Individuals traveling to regions where hepatitis B is endemic.
• Infants Born to Infected Mothers Newborns of mothers who are hepatitis B positive should receive the vaccine to prevent transmission.

2. Procedure

The administration of the hepatitis B vaccine involves several key procedural steps to ensure proper delivery and effectiveness:

• Step 1: Preparation Prior to administration, the vaccine should be prepared according to the manufacturer's instructions. This includes checking the expiration date, ensuring the vaccine is at the appropriate temperature, and gently shaking the vial to mix the contents if necessary.
• Step 2: Patient Assessment The healthcare provider should assess the patient’s medical history, including any previous allergic reactions to vaccines, and confirm the need for the hepatitis B vaccine based on the indications.
• Step 3: Site Selection The vaccine is administered intramuscularly, typically in the deltoid muscle of the upper arm for adults. The site should be cleaned with an antiseptic wipe to reduce the risk of infection.
• Step 4: Injection Using a sterile syringe and needle, the vaccine is injected into the muscle at a 90-degree angle. Care should be taken to aspirate the syringe to ensure that the needle is not in a blood vessel before injecting the vaccine.
• Step 5: Post-Injection Care After the injection, the site may be gently massaged to promote absorption, and the patient should be monitored for any immediate adverse reactions. Documentation of the vaccine administration, including the date, site, and lot number, should be completed in the patient's medical record.

3. Post-Procedure

Following the administration of the hepatitis B vaccine, patients are typically advised to remain in the healthcare setting for a short period to monitor for any immediate allergic reactions. Common post-injection reactions may include soreness at the injection site, mild fever, or fatigue, which usually resolve within a few days. Patients should be informed about the importance of completing the full three-dose schedule to ensure optimal immunity. Follow-up appointments should be scheduled to administer the subsequent doses, typically at 0, 1, and 6 months after the initial dose. It is also essential to educate patients on the signs of potential adverse reactions and when to seek medical attention.