ACOG Recommends HPV Vaccine for Pre-teens
The American College of Obstetricians and Gynecologists (ACOG) issued a new recommendation Aug. 23 that advises girls ages 11 to 12—generally before they become sexually active—to receive the human papilloma virus (HPV) vaccination. In some cases, ACOG says, it may be appropriate to vaccinate girls even younger.
“The ideal time for girls to receive the HPV vaccination is before they become sexually active and become exposed to HPV,” said Diane F. Merritt, MD, chair of ACOG’s Committee on Adolescent Health Care. “For this reason, we recommend that girls get vaccinated by age 11 or 12 and possibly as early as age 9, depending on risk factors. For those already sexually active, we also recommend the HPV vaccination for adolescents and young women up to age 26.”
HPV is a sexually transmitted viral infection which has been associated with cervical cancer. Approximately 70 percent of cervical cancers are caused by just two out of 100 identified HPV strains: HPV 16 and 18. About 90 percent of genital warts, another consequence of HPV infection, are associated with two other strains known as HPV 6 and 11.
There are currently two HPV vaccines approved by the U.S. Food and Drug Administration (FDA): Cervarix® and Gardasil®. The Cervarix® vaccine protects against the cancer-causing HPV strains 16 and 18. The Gardasil® vaccine protects against HPV 16 and 18, as well as HPV 6 and 11.
For this service, you would generally report CPT® code 90649 Human Papilloma virus (HPV) vaccine, types 6, 11, 16, 18 (quadrivalent), 3 dose schedule, for intramuscular use or 90650 Human Papilloma virus (HPV) vaccine, types 16, 18, bivalent, 3 dose schedule, for intramuscular use for the vaccine and 90471 Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections); one vaccine (single or combination vaccine/toxoid) or 90472 Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections); each additional vaccine (single or combination vaccine/toxoid) (List separately in addition to code for primary procedure) for the administration.
ACOG continues to advise against HPV testing for adolescents or young women before vaccination, ruling it pointless and unreliable.
Committee Opinion #467, “Human Papillomavirus Vaccination,” is published in the September 2010 issue of Obstetrics & Gynecology.