Gastroenterology Coding Alert

Question: Can you provide me with the codes that I need to use for Hepatitis B vaccines? What are the guidelines that I need to follow when my clinician is providing this vaccination to a Medicare patient?

Tennessee Subscriber

Answer: When your physician provides Hepatitis B vaccinations, you’ll have to use one of the following codes depending on who the vaccine is being administered to:

• 90746 — Hepatitis B vaccine, adult dosage [3 dose schedule], for intramuscular use
• 90740 — Hepatitis B vaccine, dialysis or immunosuppressed patient dosage [3 dose schedule], for intramuscular use
• 90747 — Hepatitis B vaccine, dialysis or immunosuppressed patient dosage [4 dose schedule], for intramuscular use

Use ICD-9 code V05.3 (Need for other prophylactic vaccination and inoculation against viral hepatitis), if the sole purpose of the beneficiary’s visit is to receive the hepatitis vaccine.

When providing the vaccination for a Medicare patient, you’ll need to also bill out the administration code, HCPCS G0010 (Administration of hepatitis B vaccine) in addition to the supply code. Also, you’ll have to be aware of the following coverage criteria:

Medicare provides coverage for certain beneficiaries at intermediate to high risk for the hepatitis B virus (HBV). These individuals include workers in health care professions who have frequent contact with blood or blood-derived body fluids during routine work, those with End-Stage Renal Disease (ESRD), and persons who live in the same household as an HBV carrier. There are other situations that could qualify a beneficiary as being at intermediate or high risk of contracting HBV.