Appendixes CPT copyright 2020 American Medical Association. All rights reserved. =New code ▲=Revised code #=Re-sequenced code +=Add-on code APPENDIX III. VACCINE PRODUCTS: COMMONLY ADMINISTERED PEDIATRIC VACCINES ||||||||||| 525 III. Vaccine Products: Commonly Administered Pediatric Vaccines This list was current as of September 1, 2020. For updates, visit www.aap.org/cfp (access code AAPCFP26). CPT ® Product Code Separately report the ­administration with CPT ® codes 90460–90461 or 90471–90474. See below. Manufacturer Brand of ­ Vaccine ­# Components 90702 Diphtheria and tetanus toxoids (DT), adsorbed when administered to 7 years, for IM use SP Diphtheria and tetanus toxoids adsorbed (no trade name) 2 90700 Diphtheria, tetanus toxoids, and acellular pertussis vaccine (DTaP), when administered to 7 years, for IM use SP GSK DAPTACEL Infanrix 3 90696 Diphtheria, tetanus toxoids, and acellular pertussis vaccine and inactivated poliovirus vaccine (DTaP- IPV), when administered to children 4–6 years of age, for IM use GSK SP KINRIX Quadracel 4 90697 Diphtheria, tetanus toxoids, acellular pertussis vac- cine, inactivated poliovirus vaccine, Haemophilus influenza type b PRP-OMP conjugate vaccine, and hepatitis B vaccine (DTaP-IPV-Hib-HepB), for IM use Merck/SP VAXELIS 6 90723 Diphtheria, tetanus toxoids, acellular pertussis vac- cine, Hepatitis B, and inactivated poliovirus vaccine (DTaP-HepB-IPV), for IM use GSK Pediarix 5 90698 Diphtheria, tetanus toxoids, acellular pertussis vac- cine, haemophilus influenza Type B, and inactivated poliovirus vaccine (DTaP-IPV/Hib), for IM use SP Pentacel 5 90633 Hepatitis A vaccine (HepA), pediatric/adolescent dosage, 2 dose, for IM use GSK Merck Havrix VAQTA 1 90740 Hepatitis B vaccine (HepB), dialysis or immunosup- pressed patient dosage, 3 dose, for IM use Merck Recombivax HB 1 90743 Hepatitis B vaccine (HepB), adolescent, 2 dose, for IM use Merck Recombivax HB 1 90744 Hepatitis B vaccine (HepB), pediatric/adolescent dosage, 3 dose, for IM use Merck GSK Recombivax HB Engerix-B 1 90746 Hepatitis B vaccine (HepB), adult dosage, for IM use Merck GSK Recombivax HB Engerix-B 1 90747 Hepatitis B vaccine (HepB), dialysis or immunosup- pressed patient dosage, 4 dose, for IM use GSK Engerix-B 1 90647 Hemophilus influenza B vaccine (Hib), PRP-OMP conjugate, 3 dose, for IM use Merck PedvaxHIB 1 90648 Hemophilus influenza B vaccine (Hib), PRP-T conju- gate, 4 dose, for IM use SP GSK ActHIB Hiberix 1 90651 Human Papillomavirus vaccine types 6, 11, 16, 18, 31, 33, 45, 52, 58, nonavalent (9v HPV), 2 or 3 dose schedule, for IM use Merck Gardasil 1 #90672 Influenza virus vaccine, quad (LAIV), live, intranasal use AstraZeneca FluMist Quadrivalent 1 Coding_2021.indb 525 Coding_2021.indb 525 9/15/20 2:24 PM 9/15/20 2:24 PM
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