CPT Code 90620: Meningococcal B Vaccine, 2-Dose (MenB-4C)

What is the Meningococcal B Vaccine (MenB-4C)?

CPT code 90620 refers to administering the meningococcal group B vaccine (MenB-4C). MenB-4C is a meningococcal group B vaccine composed of outer membrane vesicle proteins and recombinant antigens; unlike some conjugate vaccines, it does not use a tetanus toxoid carrier.

This vaccine protects against meningococcal illness caused by Neisseria meningitidis serotype B.  The "2-dose im" implies that this vaccination is given intramuscularly in a two-part series.  Healthcare practitioners use this code for billing and paperwork to guarantee proper compensation for vaccine administration.

Who should receive the MenB-4C vaccine?

• Adolescents and young adults (16–23 years): Vaccination is based on shared clinical decision-making, with a preferred age range of 16–18 years to maximize protection during the period of highest risk.
• Individuals aged 10 years and older are at increased risk: This includes those with certain medical conditions (e.g., complement component deficiencies, asplenia), microbiologists routinely exposed to Neisseria meningitidis, and individuals identified to be at increased risk during a serogroup B meningococcal disease outbreak.

Vaccine composition and administration

Bexsero® is an outer membrane vesicle vaccine containing meningococcal recombinant proteins. It is preservative-free and administered intramuscularly. The vaccine is part of the broader category of vaccine-preventable diseases and is included in immunization practices aimed at disease control and prevention.

Documentation requirements

Accurate documentation is essential when reporting CPT code 90620 for the meningococcal group B vaccine (MenB-4C). The elements listed are correct and align with CDC and billing guidelines.

Here's further information for each requirement:

• Vaccine name, manufacturer, lot number, and expiration - Record the full vaccine product information (e.g., Bexsero®, outer membrane vesicle vaccine), including the lot number and expiration date, as required for safety tracking and compliance.
• Route (IM), site of administration - Note that the vaccine is administered intramuscularly (IM), typically in the deltoid or anterolateral thigh, to comply with vaccine administration documentation standards.
• Informed consent and education - Document that the patient (or guardian) received appropriate vaccine information, such as the CDC’s VIS, and provided informed consent, especially if shared clinical decision-making was used.
• Date and reason for immunization - Include the date of service, whether the immunization was routine for young adults or due to increased risk for invasive meningococcal disease (e.g., immunosuppression, outbreak exposure).
• Administration record and any adverse reactions - Record the vaccine administration details under services rendered, including dose (0.5 ml) and any solicited adverse reactions, such as injection site pain or severe allergic reaction if observed.

These documentation elements support disease control and prevention, adherence to immunization practices, and proper reporting under healthcare providers' services performed for vaccine-preventable diseases like meningococcal serogroup B.

Billing Guidelines

CPT code 90620 is used to report the administration of the meningococcal group B vaccine (MenB-4C) for active immunization against invasive meningococcal disease. This intramuscular injection is typically part of appropriate medical treatment for adolescents and individuals at increased risk.

Billing for the 90620 CPT code must follow these key guidelines:

• Report 90620 as a product-specific CPT code, as maintained by the American Medical Association, for the MenB-4C vaccine.
• It must be billed separately from the vaccine administration code (e.g., 90471 for the first IM injection), unless payer-specific policies bundle the product and administration.
• The dose administered is 0.5 ml, and it is typically part of a 2-dose schedule.
• Ensure proper linkage with an ICD-10 code that supports the medical necessity of the immunization (e.g., routine vaccination or high-risk status).
• If applicable, document and bill for shared clinical decision-making, particularly in healthy adolescents for whom the vaccine is not universally required.
• This toxoid carrier-based vaccine should not be confused with other toxoid-based products, such as tetanus toxoid vaccines; billing must reflect the correct particular CPT code for the product used.

Always verify payer-specific requirements, especially regarding reimbursement eligibility, frequency limitations, and the need for prior authorization in some high-risk cases.