CPT 2016 Code Changes

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1 CPT 2016 Code Changes Code Changes - Medicine New CPT 2016 New Codes Code Description Removal impacted cerumen using irrigation/lavage, unilateral Meningococcal recombinant protein and outer membrane vesicle vaccine, serogroup B (MenB), 2 dose schedule, for Meningococcal recombinant lipoprotein vaccine, serogroup B (MenB), 3 dose schedule, for Cholera vaccine, live, adult dosage, 1 dose schedule, for oral use Advice CPT 2016 adds to report when a r washes out (irrigates/lavages) entrapped wax (cerumen) from a patient s external ear canal. A already existed for cerumen removal using an instrument, but no existed for lavage. CPT released and 90621, two new formulations of recombinant meningococcal vaccines, on Nov. 1, 2014, for implementation Feb. 1, 2015; however, the s won't appear in the CPT manual until Code is an intramuscular, two-dose schedule, serogroup B Meningococcal recombinant protein and outer membrane vesicle vaccine and is an intramuscular, three-dose Meningococcal recombinant lipoprotein vaccine, serogroup B (MenB). These vaccines were approved by the FDA in early CPT released and 90621, two new formulations of recombinant meningococcal vaccines, on Nov. 1, 2014, for implementation Feb. 1, 2015; however, the s won't appear in the CPT until Code is an intramuscular, two-dose schedule, serogroup B Meningococcal recombinant protein and outer membrane vesicle vaccine and is an intramuscular, three-dose Meningococcal recombinant lipoprotein vaccine, serogroup B (MenB). These vaccines were approved by the FDA in early CPT 2016 adds a single dose, oral cholera vaccine for adults with 90625, Cholera vaccine, live, adult dosage, 1 dose schedule, for oral use. Until now, the set included a only for an injectable form of cholera vaccine.

2 90697 Diphtheria, tetanus toxoids, acellular pertussis vaccine, inactivated poliovirus vaccine, Haemophilus influenzae type b PRP-OMP conjugate vaccine, and hepatitis B vaccine (DTaP-IPV-Hb-HepB), for Revised CPT released 90697, Diphtheria, tetanus toxoids, acellular pertussis vaccine, inactivated poliovirus vaccine, Haemophilus influenza type b PRP-OMP conjugate vaccine, and hepatitis B vaccine (DTaP-IP- -Hib-HepB), for intramuscular, use in mid-2014, but it wasn't FDA-approved and didn't appear in the 2015 manual. It will appear in the 2016 manual. Code is a new formulation and joins a large group of other diphtheria/tetanus toxoid combination vaccines ( ). CPT 2016 Revised Codes Code Description Hepatitis A vaccine (HepA), adult dosage, for Hepatitis A vaccine (HepA), pediatric/adolescent dosage-2 dose schedule, for Hepatitis A vaccine (HepA), pediatric/adolescent dosage-3 dose schedule, for Meningococcal conjugate vaccine, serogroups C & Y and Hemophilus influenza BHaemophilus influenzae type b vaccine (Hib-MenCY), 4 dose schedule, when administered to children months of age, for Hemophilus influenzahaemophilus influenzae type b vaccine (Hib), PRP-OMP conjugate (, 3 dose schedule), for Advice CPT 2016 changes the wording of the official descriptor for to include the abbreviation "(HepA)" after the name of the vaccine. CPT 2016 changes the wording of the official descriptor for to include the abbreviation "(HepA)" after the name of the vaccine. CPT 2016 changes the wording of the official descriptor for to include the abbreviation "(HepA)" after the name of the vaccine. CPT 2016 changes the wording of the official descriptor for from "2-15 months of age" to "2-18 months of age." CPT 2016 removes the parentheses from "3-dose schedule" in the official descriptor for and changes the vaccine to "Haemophilus influenzae type" b Hemophilus influenzahaemophilus influenzae type b vaccine (Hib), PRP-T conjugate (, 4 dose schedule), for CPT 2016 removes the parentheses from "4-dose schedule" in the official descriptor for and changes the vaccine to "Haemophilus influenzae type" b.

3 90649 Human Papilloma virus (HPV)Papillomavirus vaccine, types 6, 11, 16, 18 (quadrivalent), quadrivalent (4vHPV), 3 dose schedule, for CPT 2016 removes the abbreviation "(HPV)" and the parentheses from "quadrivalent," changes the description to "Papillomavirus" and adds "(4vHPV)" after the word quadrivalent in the official descriptor for Human Papilloma virus (HPV)Papillomavirus vaccine, types 16, 18, bivalent (2vHPV), 3 dose schedule, for Human Papillomavirus vaccine types 6, 11, 16, 18, 31, 33, 45, 52, 58, nonavalent (HPV)(9vHPV), 3 dose schedule, for Influenza vaccine, inactivated (IIV), subunit, adjuvanted, for Influenza virus vaccine, trivalent (IIV3), split virus, preservative free, when administered to children 6-35 months of age, for intramuscular use Influenza virus vaccine, trivalent (IIV3), split virus, preservative free, when administered to individuals 3 years and older, for intramuscular use Influenza virus vaccine, trivalent (IIV3), split virus, when administered to children 6-35 months of age, for Influenza virus vaccine, trivalent (IIV3), split virus, when administered to individuals 3 years of age and older, for Influenza virus vaccine, trivalent, live (LAIV3), for intranasal use Influenza virus vaccine (cciiv3), derived from cell cultures, subunit, preservative and antibiotic free, for Influenza virus vaccine (IIV), split virus, preservative free, enhanced immunogenicity via increased antigen content, for CPT 2016 removes "(HPV)" following the name of the vaccine, changes the name to "Papillomavirus" and adds "(2vHPV)" after bivalent in the official descriptor for CPT 2016 replaces "(HPV)" after nonvalent with "(ovhpv)" in the official descriptor for CPT 2016 adds "(IIV)" after "Influenza vaccine, inactivated" in the official descriptor for CPT 2016 adds "(IIV3)" after "Influenza virus vaccine, trivalent" in the official descriptor for CPT 2016 adds "(IIV3)" after "Influenza virus vaccine, trivalent" in the official descriptor for CPT 2016 adds "(IIV3)" after "Influenza virus vaccine, trivalent" in the official descriptor for CPT 2016 adds "(IIV3)" after "Influenza virus vaccine, trivalent" in the official descriptor for CPT 2016 adds "(LAIV3)" after "Influenza virus vaccine, trivalent, live" in the official descriptor for CPT 2016 adds "(cciiv3)" after "Influenza CPT 2016 adds "(IIV)" after "Influenza

4 90664 Influenza virus vaccine, live (LAIV), pandemic formulation, live, for intranasal use Influenza virus vaccine (IIV), pandemic formulation, split virus, preservative free, for Influenza virus vaccine (IIV), pandemic formulation, split virus, adjuvanted, for Influenza virus vaccine (IIV), pandemic formulation, split virus, for Pneumococcal conjugate vaccine, 13 valent (PCV13), for Influenza virus vaccine, quadrivalent, live (LAIV4), for intranasal use Influenza virus vaccine, trivalent (RIV3), derived from recombinant DNA (RIV3), hemagglutinin (HA) protein only, preservative and antibiotic free, for Rotavirus vaccine, pentavalent (RV5), 3 dose schedule, live, for oral use Rotavirus vaccine, human, attenuated (RV1), 2 dose schedule, live, for oral use Influenza virus vaccine, quadrivalent (IIV4), split virus, preservative free, when administered to children 6-35 months of age, for Influenza virus vaccine, quadrivalent (IIV4), split virus, preservative free, when administered to individuals 3 years of age and older, for Influenza virus vaccine, quadrivalent (IIV4), split virus, when administered to children 6-35 months of age, for Influenza virus vaccine, quadrivalent (IIV4), split virus, when administered to individuals 3 years of age and older, for CPT 2016 adds " live (LAIV)" after "Influenza virus vaccine" in the official descriptor for and removes "live" that follows "forumulation" in the 2015 descriptor. CPT 2016 adds "(IIV)" after "Influenza CPT 2016 adds "(IIV)" after "Influenza CPT 2016 adds "(IIV)" after "Influenza CPT 2016 adds "(PCV13)" after "Pneumococcal conjugate vaccine, 13 valent" in the official descriptor for CPT 2016 adds "(LAIV4)" after "Influenza virus vaccine, quadrivalent, live" in the official descriptor for CPT 2016 moves (RIV3) to follow Influenza virus vaccine, trivalent in the official descriptor for CPT 2016 adds "(RV5)" after "Rotavirus vaccine, pentavalent" in the official descriptor for CPT 2016 adds "(RV1)" after "Rotavirus vaccine, human, attenuated" in the official descriptor for CPT 2016 adds "(IIV4)" after "Influenza virus vaccine, quadrivalent" in the official descriptor for CPT 2016 adds "(IIV4)" after "Influenza virus vaccine, quadrivalent" in the official descriptor for CPT 2016 adds "(IIV4)" after "Influenza virus vaccine, quadrivalent" in the official descriptor for CPT 2016 adds "(IIV4)" after "Influenza virus vaccine, quadrivalent" in the official descriptor for

5 90696 Diphtheria, tetanus toxoids, acellular pertussis vaccine and inactivated poliovirus vaccine, inactivated (DTaP-IPV), when administered to children 4 through 6 years of age, for Diphtheria, tetanus toxoids, acellular pertussis vaccine, hhaemophilus influenza Type Binfluenzae type b, and inactivated poliovirus vaccine (DTap-IPV/Hib), for Diphtheria and tetanus toxoids adsorbed (DT) adsorbed when administered to individuals younger than 7 years, for Tetanus and diphtheria toxoids adsorbed (Td) adsorbed, preservative free, when administered to individuals 7 years or older, for Varicella virus vaccine (VAR), live, for subcutaneous use Pneumococcal polysaccharide vaccine, 23- valent (PPSV23), adult or immunosuppressed patient dosage, when administered to individuals 2 years or older, for subcutaneous or Meningococcal polysaccharide vaccine (any group(s)), serogroups A, C, Y, W-135, quadrivalent (MPSV4), for subcutaneous use Meningococcal conjugate vaccine, serogroups A, C, Y and W-135, quadrivalent (MenACWY), for Zoster (shingles) vaccine (HZV), live, for subcutaneous injection Hepatitis B vaccine (HepB), adult dosage (, 2 dose schedule), for Hepatitis B vaccine (HepB), dialysis or immunosuppressed patient dosage (, 3 dose schedule), for CPT 2016 changes poliovirus vaccine, inactivated (DTaP-IPV) to inactivated poliovirus vaccine (DTaP-IPV) in the official descriptor for CPT 2016 changes influenza Type B, and poliovirus vaccine to influenza tupe b, and inactived poliovirus vaccine (DTap-IPV/Hib) in the official descriptor for CPT 2016 moves "absorbed" from after (DT) to before (DT) in the official descriptor for CPT 2016 moves "absorbed" from after (Td) to after (Td) in the official descriptor for CPT 2016 adds "(VAR)" after "Varicella CPT 2016 adds "(PPSV23)" after "Pneumococcal polysaccharide vaccine, 23- valent" in the official descriptor for CPT 2016 changes the words "(any group(s))" in the official descriptor to "serogroups A, C, Y, W-135, quadrivalent (MPSV4)" for CPT 2016 adds "(MenACWY)" after the word "quadrivalent" in the official descriptor for CPT 2016 adds "(HZV)" after the word "vaccine" in the official descripto for from 2 dose schedule in the official descriptor for from 3 dose schedule in the official descriptor for

6 90743 Hepatitis B vaccine (HepB), adolescent (, 2 dose schedule), for Hepatitis B vaccine (HepB), pediatric/adolescent dosage (, 3 dose schedule), for Hepatitis B vaccine (HepB), adult dosage (, 3 dose schedule), for Hepatitis B vaccine (HepB), dialysis or immunosuppressed patient dosage (, 4 dose schedule), for Hepatitis B and Hemophilus influenzahaemophilus influenzae type b vaccine (HepB-Hib)(Hib-HepB), for Deleted from 2 dose schedule in the official descriptor for from 3 dose schedule in the official descripto for from 3 dose schedule in the official descriptor for from 4 dose schedule in the official descriptor for CPT 2016 changes Hemophilus influenza to "Haemophilus influenzae type" and changes (HepB-Hib) to "(Hib-HepB) in the official descriptor for CPT 2016 Deleted Codes Code Description Hemophilus influenza b vaccine (Hib), HbOC conjugate (4 dose schedule), for Hemophilus influenza b vaccine (Hib), PRP-D conjugate, for booster use only, Crosswalk Code s for s for Advice The 2016 set as an obsolete vaccine. The 2016 set as an obsolete vaccine.

7 90669 Pneumococcal conjugate vaccine, 7 valent, for Typhoid vaccine, heat- and phenolinactivated (H-P), for subcutaneous or intradermal use Typhoid vaccine, acetone-killed, dried (AKD), for subcutaneous use (U.S. military) Tetanus toxoid adsorbed, for s for s for s for s for The 2016 set At time, CPT an indication as to the reason for deletion of. CPT also a for but check with the individual payers for their policies on s to report for service. Refer to the CPT manual also for further direction as you may be able to report service or procedure using an unlisted. Remember to send supporting documentation to payers with any claim containing an unlisted. Keep in mind that CPT recommend the use of unlisted procedures on a regular basis. The 2016 set as an obsolete vaccine. The 2016 set as an obsolete vaccine. The 2016 set as an obsolete vaccine.

8 90704 Mumps virus vaccine, live, for subcutaneous use Measles virus vaccine, live, for subcutaneous use Rubella virus vaccine, live, for subcutaneous use Measles and rubella virus vaccine, live, for subcutaneous use Poliovirus vaccine, (any type[s]) (OPV), live, for oral use s for s for s for s for s for The 2016 set as an obsolete vaccine. The 2016 set as an obsolete vaccine. The 2016 set as an obsolete vaccine. The 2016 set as an obsolete vaccine. The 2016 set as an obsolete vaccine.

9 90719 Diphtheria toxoid, for intramuscular use Diphtheria, tetanus toxoids, and whole cell pertussis vaccine and Hemophilus influenza B vaccine (DTP-Hib), for Diphtheria, tetanus toxoids, and acellular pertussis vaccine and Hemophilus influenza B vaccine (DTaP/Hib), for s for s for s for Cholera vaccine for injectable use s for Plague vaccine, for s for The 2016 set as an obsolete vaccine. The 2016 set as an obsolete vaccine. The 2016 set as an obsolete vaccine. The 2016 set as an obsolete vaccine. The 2016 set as an obsolete vaccine.

10 90735 Japanese encephalitis virus vaccine, for subcutaneous use s for The 2016 set as an obsolete vaccine.

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