2025 CPT code 90636

Hepatitis A and B vaccine (HepA-HepB), adult dosage, for intramuscular use.

Always identify the specific vaccine product. If administering multiple vaccines at the same encounter, report each vaccine with its corresponding administration code.Refer to the AMA CPT® website for the most up-to-date vaccine code descriptors and coding guidelines.

Modifiers may be applicable in specific circumstances (e.g., 25 for a significant portion of the service, 59 for distinct procedural services), but modifier 51 should not be used with code 90636 when bundled with administration codes.

Medical necessity for this vaccination is typically established based on the patient's risk factors, such as travel to high-risk areas, occupational exposure to blood-borne pathogens, or underlying conditions increasing susceptibility to Hepatitis A or B infections. Payer-specific guidelines for medical necessity should be checked.

The clinical responsibility includes administering the vaccine intramuscularly after appropriate patient preparation, providing pre- and post-vaccine counseling, including instructions and precautions, and documenting the procedure and the vaccine administered.

IMPORTANT Separate codes exist for other Hepatitis A and B vaccines, including single-antigen vaccines and those with different dosages or administration routes.Combination vaccines should be coded as a single unit; do not code each component separately.

In simple words: This code is for a shot that protects against hepatitis A and B.It's given in the muscle of an adult's arm or leg to help prevent these liver infections.

This CPT code 90636 represents the administration of a combined Hepatitis A and B vaccine (HepA-HepB) to an adult patient via the intramuscular route.The vaccine is a combined preparation providing immunity against both Hepatitis A and Hepatitis B viruses.This code is specifically for the adult dosage and should not be used for pediatric patients.Appropriate administration and patient counseling are integral to this procedure.

Example 1: A 25-year-old adult traveling to a region with high Hepatitis A and B prevalence receives the combined HepA-HepB vaccine before their trip. The code 90636 would be used to bill for the vaccine administration., A healthcare worker, exposed to blood-borne pathogens, receives the HepA-HepB vaccine as part of their occupational health plan. Code 90636 is used to bill for the vaccine administration., A 30-year-old patient with chronic liver disease (not related to Hepatitis A or B) decides to get vaccinated against Hepatitis A and B for preventative measures. Code 90636 is used to bill for the vaccine administration.

Documentation should include the type of vaccine administered (HepA-HepB), the date of administration, the route of administration (intramuscular), the patient's age and weight, and any adverse reactions noted.Patient counseling regarding risks, benefits and precautions is also crucial.

** Always refer to the most current CPT codebook and payer guidelines for accurate billing.This information is for guidance only and should not replace professional medical coding advice.

  • Payment Status: Active
  • Modifier TC rule: A Technical Component (TC) modifier does not typically apply to this code as it represents the vaccine itself and not a technical component of a larger procedure.
  • Specialties:Infectious Disease, Internal Medicine, Family Medicine, Occupational Medicine, Travel Medicine
  • Place of Service:Office, Clinic, Hospital, Other Place of Service
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