UnitedHealthcare: Gardasil Covered for Males

UnitedHealthcare has expanded its coverage of Gardasil®. Effective Feb. 1, 2012, the insurer will cover the HPV4 vaccine for both females and males aged 9-26 years, according to UnitedHealthcare’s March 2012 Network Bulletin.

This coverage is based on new recommendations made by the Advisory Committee on Immunization Practices (ACIP) in October 2011 for Human Papillomavirus Quadrivalent (Types 6, 11, 18, and 18) Vaccine, Recombinant (Gardasil).

Human papilloma virus (HPV) can cause cervical, vaginal, and vulvar cancers in females, and genital warts in both males and females, according to Merck & Co., Inc.—the manufacturer of Gardasil.

Merck says the commonly used codes below may apply to private payer reimbursement for vaccination with Gardasil:

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CPT® Descriptor
90649 Human Papilloma virus (HPV) vaccine, types 6, 11, 16, 18 (quadrivalent), 3 dose schedule, for intramuscular use
90471 Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections); 1 vaccine (single or combination vaccine/toxoid)
ICD-9-CM Descriptor
V04.89 Need for prophylactic vaccination and inoculation against other viral diseases
V05.8 Need for prophylactic vaccination and inoculation against other specified disease

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