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AMERICANMEDICALASSOCIATION
Summer 2015,Vol. 1
9
ESSENTIALCPT®CODINGRESOURCES
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historical changesdatingback to2000. This invaluable
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Medicine
Rationale
Anew vaccineproduct code (90651) has beenestablished
fora vaccine that protects againstnine (nonavalent) types
ofHumanPapillomavirus (HPV) (6, 11, 16,18,31,33, 45,
52, 58).Currently, code 90650 isused to report two (biva-
lent) types (16,18),and code 90649 is used to report four
(quadrivalent) types (6,11,16,18).The nonavalent vac-
cine,once licensed, is expected tobe available for admin-
istration tohealthy females9 through 26 yearsof ageand
healthymales9 to15 yearsofage.
Code 90651willappear in theCPT codebookwith theUS
FoodandDrugAdministration (FDA)approval pending
symbol (
~
).Updates on the FDA status of this codewill
be reflected on theAMACPTwebsiteunderCategory I
VaccineCodes (
-
resources/solutions-managing-your-practice/coding-bill-
ing-insurance/cpt/about-cpt/category-i-vaccine-codes.
shtml) and in subsequentpublications of theCPT code-
book.The serviceassociatedwith the administrationof
thenonavalentHPV vaccine is reported separatelyusing
immunization administration for vaccines/toxoids codes
90460-90474.
Clinical Example (90651)
Ahealthy12-year-oldmale or femalewho isnot allergic
to the ingredientspresents for the vaccine.A catch-up
vaccination for femalesup to age26 and formalesup to
age15would also be common.
Descriptionof Procedure (90651)
The service associatedwith vaccine administration is
reported separatelyusing ImmunizationAdministration
forVaccines/Toxoids codes (90460-90474).
▲
90654
Influenza virus vaccine, trivalent (IIV3), split virus,
preservative-free, for intradermal use
#
~
●
90630
Influenza virus vaccine, quadrivalent (IIV4), split virus,
preservative free, for intradermal use
Rationale
A vaccineproduct code (90630) hasbeenestablished for a
quadrivalent intradermal influenza virus vaccineantici-
pated to receiveUS Food andDrugAdministration (FDA)
approvalby theend of2014 foruse in the 2015/2016
influenza season.This vaccine replaces last season’s
intradermal influenza vaccine reportedwith trivalent intra-
dermal influenza vaccine code90654.Code90630will
appear in theCPT codebookwith the FDA approval
Vaccines, Toxoids
Codes 90476-90749 identify the vaccineproduct only.
To report the administration of a vaccine/toxoid, the
vaccine/toxoidproduct codes90476-90749mustbeused
in addition to an immunization administration code(s)
90460, 90461,90471,90472, 90473,90474.Modifier
51 shouldnotbe reportedwith vaccine/toxoid codes
90476-90749,when reported in conjunctionwith
administration codes90460, 90461, 90471, 90472,
90473, 90474.
Separate codes are available for combination vaccines
(eg,DTP-Hib,DTaP-Hib,HepB-Hib). It is inappropri-
ate to code each component of a combination vaccine
separately. If a specific vaccine code isnot available, the
unlistedprocedure code shouldbe reported,until anew
code becomes available.
The vaccine/toxoid abbreviations listed in codes90476-
90748 reflect themost recentUS vaccine abbreviations
referencesused in theAdvisoryCommittee on Immuni-
zationPractices (ACIP) recommendations at the time of
CPT code setpublication. Interimupdates to vaccine
codedescriptorswill bemade following abbreviation
approval by theACIP on a timelybasis via theAMA
CPTwebsite (
resources/solutions-managing-your-practice/coding-bill-
ing-insurance/cpt/about-cpt/category-i-vaccine-codes.
page).The accuracy of theACIP vaccine abbreviation
designations in theCPT code setdoesnot affect the
validity of the vaccine code and its reporting function.
90632
HepatitisA vaccine,adult dosage, for intramuscular use
Rationale
The third paragraph of the introductory guidelines for the
Vaccines, Toxoids subsection has been revised to provide
greater specificity by identifying each code thatmay be
reportedwith the vaccineproduct codes to include codes
90460, 90461, and 90471,90472, 90473,90474. Theweb-
site address listed in the introductory language has also
been updated to reflect amore direct link to vaccine infor-
mation on theAMACPTwebsite. (See the secondpara-
graph of the introductory language.)
~
●
90651
Human Papillomavirus vaccine types 6, 11,16,18, 31,33,
45, 52, 58, nonavalent (HPV),3 dose schedule, for
intramuscular use
CPTCHANGES 2016
Medicine
▲
Revised code
●
New code
Containsnewor revised text
Modifier51exempt
AmericanMedicalAssociation
17
300
Index
CPTCHANGES 2016
Index
Anesthesia,Abdomen
Anesthesia, Liver
Head.................... 00210‑00222, 00300
Muscles ..........................00300
Nerves ...........................00300
Heart.................... 00560‑00567, 00580
CoronaryArteryBypass
Grafting ....................00566, 00567
Electrophysiology/Ablation ...........00537
Transplant ........................00580
Hepatectomy
Partial............................00792
HerniaRepair
Abdomen
Lower .................... 00830‑00836
Upper .............. 00750‑00752, 00756
Hip............................ 01200‑01215
Humerus..... 01620, 01730, 01742‑01744, 01758
Hysterectomy .........................01962
Cesarean ...................01963, 01969
Radical...........................00846
Vaginal...........................00944
Hysterosalpingography..................00952
Hysteroscopy..........................00952
InducedAbortion.......................01966
InferiorVenaCava Ligation ..............00882
Nerve ...................... 01991‑01992
IntegumentarySystem
Anterior Trunk .....................00400
Arm,Upper........................00400
Axilla ............................00400
Elbow............................00400
Extremity .........................00400
Forearm ..........................00400
Hand.............................00400
Head.............................00300
Knee.............................00400
Leg, Lower ........................00400
Leg,Upper ........................00400
Neck.............................00300
Perineum .........................00400
PoplitealArea .....................00400
PosteriorPelvis ....................00300
PosteriorTrunk.....................00300
Shoulder..........................00400
Wrist ............................00400
Intestines
Endoscopy ........................00810
Intracranial Procedures............00210‑00218,
00220‑00222
IntraoralProcedures .............. 00170‑00176
Intrathoracic Procedures
Bronchi.....................00539,00548
Trachea.....................00539, 00548
IntrathoracicSystem........00500,00520‑00529,
00530‑00539, 00540‑00548,
00550, 00560‑00567, 00580
Iridectomy............................00147
KeenOperation........................00604
Kidney............. 00862, 00868,00872‑00873
Knee..00400, 01320, 01340, 01360,01380‑01404,
01420, 01430‑01432, 01440‑01444
KneeSkin............................00400
Laminectomy..........................00604
Laparoscopy.............. 00790‑00792, 00840
Larynx.........................00320,00326
Leg
Lower...................... 01462‑01522
Upper ...................... 01200‑01274
LifeSupport forOrganDonor . . . . . . . . . . . . .01990
Ligation
Fallopian Tube .....................00851
Lithotripsy...................... 00872‑00873
Liver...........................00702, 00796
Childbirth
CesareanDelivery ........... 01961, 01963,
01968‑01969
ExternalCephalicVersion ............01958
VaginalDelivery..............01960, 01967
Clavicle........................00450, 00454
Cleft LipRepair........................00102
CleftPalateRepair .....................00172
Colpectomy...........................00942
Colporrhaphy..........................00942
Colpotomy............................00942
CornealTransplant .....................00144
Craniectomy ..........................00211
Cranioplasty..........................00215
Craniotomy...........................00211
Culdoscopy...........................00950
Cystectomy . . . . . . . . . . . . . . . . . . . . . . . . . . .00864
Cystolithotomy ........................00870
Decortication..........................00542
Defibrillator.....................00534,00560
Diaphragm...................... 00540‑00541
Disarticulation
Hip ..............................01212
Knee.............................01404
Shoulder..........................01634
DrugAdministration
Epidural orSubarachnoid.............01996
Ear............................ 00120‑00126
Elbow ................... 00400,01710‑01782
Electrocoagulation
IntracranialNerve ..................00222
ElectroconvulsiveTherapy ...............00104
Embolectomy
Arm,Upper........................01772
Femoral ..........................01274
FemoralArtery.....................01274
Forearm,Wrist,andHand ............01842
Leg, Lower ........................01502
Endoscopy
Arm, Lower........................01830
Gastrointestinal....................00740
Intestines.........................00810
Uterus............................00952
Vagina ...........................00950
Esophagus......................00320,00500
ExternalCephalicVersion................01958
Eye............................ 00140‑00148
Cornea ...........................00144
Iridectomy ........................00147
Iris ..............................00147
Lens .............................00142
Eyelid................................00103
FacialBones....................00190,00192
FallopianTube
Ligation ..........................00851
FemoralArtery
Embolectomy ......................01274
Ligation ..........................01272
Femur ............. 01220‑01234, 01340, 01360
Fibula.......................... 01390‑01392
Foot........................... 01462‑01522
Forearm.............01810‑01820, 01830‑01860
Fowler‑StephensOrchiopexy .............00930
GastrocnemiusRecession................01474
GastrointestinalEndoscopy ..............00740
Genitalia
Female ..................... 00940‑00952
Male....................... 00920‑00938
GreatVessels ofChest............ 00560‑00563
Hand.........00400,01810‑01820,01830‑01860
HarringtonRodTechnique ...............00670
HalstedRepair ............. 00750‑00756
Intraperitoneal....00790‑00797, 00840‑00851
AbdominoperinealResection . . . . . . . . . . . . .00844
Abortion
Incomplete........................01965
Induced...........................01966
Achilles TendonRepair..................01472
AcromioclavicularJoint .................01620
Adrenalectomy ........................00866
Amniocentesis ........................00842
Aneurysm
Axillary‑Brachial....................01652
Knee.............................01444
PoplitealArtery ....................01444
Angiography..........................01920
Ankle.................... 00400,01462‑01522
AnorectalProcedure....................00902
Anus................................00902
Arm
Lower.....00400,01810‑01820,01830‑01860
Upper ................ 00400,01710‑01782
Arrhythmias...........................00410
Arteriography .........................01916
Arteriovenous Fistula ...................01432
Arthrography
Arthroplasty
Hip ........................ 01214‑01215
Knee.............................01402
Arthroscopic Procedures
Ankle ............................01464
Elbow...................... 01732‑01740
Foot .............................01464
Hip ..............................01202
Knee.......................01382,01400
Shoulder.................... 01622‑01638
Wrist ...................... 01829‑01830
Axilla.................... 00400,01610‑01682
BackSkin.............................00300
Batch‑Spittler‑McFaddinOperation ........01404
Biopsy
Ear ..............................00120
Liver .............................00702
SalivaryGlands ....................00100
Bladder........................00870,00912
Brain...............00210‑00218, 00220‑00222
Breast......................... 00402‑00406
Bronchi..............................00542
IntrathoracicRepairofTrauma ........00548
Reconstruction.....................00539
Bronchoscopy .........................00520
Burns
Debridementand/or Excision ... 01951‑01953
BurrHole.............................00214
BypassGraft
Leg, Lower ........................01500
Leg,Upper ........................01270
Shoulder,Axillary.............01654,01656
CardiacCatheterization .................01920
Cast
Knee.............................01420
CastApplication
Forearm,Wrist,andHand ............01860
Leg ..............................01490
Pelvis ............................01130
Shoulder....................01680,01682
CentralVenousCirculation...............00532
CervicalCerclage ......................00948
Cervix ...............................00948
CesareanDelivery................01961,01963
Chest..............00410,00470‑00474, 00522,
00530‑00539, 00542‑00548, 00550
ChestSkin............................00400
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