Meningococcal Conjugate Vaccine Solution For Intramuscular Injection Cpt Code : Billing Guidelines
Effective with date of service Nov. 13, 2020, the Medicaid and NC Health Choice programs cover meningococcal conjugate vaccine, solution for intramuscular injection for use in the Physician Administered Drug Program when billed with HCPCS code 90619 – Meningococcal conjugate vaccine, serogroups A, C, W, Y, quadrivalent, tetanus toxoid carrier , for intramuscular use.
Strength/Package Size: Solution for injection in 0.5 mL single-dose vial.
Indicated for active immunization for the prevention of invasive meningococcal disease caused by Neisseria meningitidis serogroups A, C, W, and Y. MenQuadfi vaccine is approved for use in individuals two years of age and older. MenQuadfi does not prevent N. meningitidis serogroup B disease.
Recommended Dose: 0.5 mL dose for intramuscular injection. See full prescribing information for further detail.
How Does Meningitis Spread
Each form of meningitis spreads differently. Viral and bacterial will spread person-to-person through air droplets, kissing or nasal secretions. Fungal and parasitic are ususally cause by environmental factors.
Viral and bacterial are the most common variants. They are most often spread within communities that live or work together. Dorm living, close contact and shared facilities are some common risk areas.
Some regions of the world are at an increased risk for meningitis. These include the meningitis belt in Africa and Saudi Arabia during the Hajj.
What Are The Side Effects From The Meningococcal Vaccines
With any vaccine, there is the potential of a severe allergic reaction within a few minutes to a few hours after the shot. But the likelihood that the meningococcal vaccines would cause a severe reaction is extremely slight.
About one out of every two people who get the shot experience mild reactions such as redness or a mild pain where the shot was given. Those usually go away in one to two days. A small percentage of people develop a mild fever.
There have been reports that a few people have been diagnosed with Guillain-Barre syndrome after receiving MCV4. But experts say it occurs so rarely that it’s not possible to tell if it’s related to the vaccine or coincidental.
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Are Students In College At Risk For Meningococcal Disease
In the 1990s, college freshmen living in residence halls were identified as being at increased risk for meningococcal disease. Meningococcal disease and outbreaks in young adults were primarily due to serogroup C. However, following many years of routine vaccination of young people with quadrivalent meningococcal conjugate vaccine , serogroup B is now the primary cause of meningococcal disease and outbreaks in young adults. Among the approximately 9 million students aged 18-21 years enrolled in college, there are an average of 20 cases and 2-4 outbreaks due to serogroup B reported annually.
Although incidence of serogroup B meningococcal disease in college students is low, college students aged 18-21 years are at increased risk compared to non-college students. The close contact in college residence halls, combined with certain behaviors , may put college students at increased risk.
Is there a vaccine against meningococcal disease?
Yes, there are 2 different meningococcal vaccines.
Who Is At Most Risk For Meningococcal Disease
High-risk groups include anyone with a damaged spleen or whose spleen has been removed, those with persistent complement component deficiency , HIV infection, those traveling to countries where meningococcal disease is very common, microbiologists who routinely work with the bacteria and people who may have been exposed to meningococcal disease during an outbreak. People who live in certain settings such as college dormitories and military housing are also at greater risk of disease from some serotypes.
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Why Do Teens Need A Meningococcal Vaccine
Of the 1,000-2,600 people who get meningococcal disease each year, one-third are teens and young adults. Ten percent to 15% of those who get sick with the disease will die, even with antibiotic treatment. As many as 20% of the survivorswill have permanent side effects, such as hearing loss or brain damage.
The immunization can help prevent this serious disease.
Students Under 22 Years Of Age Who Will Take Any Face
Documentation must be submitted at least 10 days prior to the student’s first in-person class.
Effective Jan. 1, 2014, state law requires students who will be under age 22 on their first day of class at a public, private or independent institution of higher education in Texas to provide proof of immunization for bacterial meningitis. The vaccination or booster dose must have been received during the five years prior to enrollment and at least ten days before the start of classes.
Students who have been previously enrolled at Texas State and are enrolling following a break in enrollment of at least one fall or spring semester will be subject to the vaccination requirement. Students transferring from another institution of higher education will also be subject to the vaccination requirement.
Texas State requires you to meet this requirement before you will be allowed to register for classes.
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For Medicaid And Nc Health Choice Billing
- The ICD-10-CM diagnosis code required for billing is/are: Z23 – Encounter for immunization
- Providers must bill with HCPCS code: 90619 – Meningococcal conjugate vaccine, serogroups A, C, W, Y, quadrivalent, tetanus toxoid carrier , for intramuscular use
- One Medicaid and NC Health Choice unit of coverage is: 0.5 mL
- The maximum reimbursement rate per unit is: $152.15
- Providers must bill 11-digit NDCs and appropriate NDC units. The NDCs is/are: 49281-0590-05, 49281-0590-58
- The NDC units should be reported as UN1
When Are Meningococcal Vaccines Given
Vaccination with MenACWY is recommended:
- when kids are 11 or 12 years old, with a booster given at age 16
- for teens 1318 years old who haven’t been vaccinated yet
Those who have their first dose between the ages of 1315 should get a booster dose between the ages of 1618. Teens who get their first dose after age 16 won’t need a booster dose.
Kids and teens who are at higher risk for meningococcal disease need the full series of MenACWY vaccines, even if they’re younger than 11 years old. This includes kids who:
- live in or travel to countries where the disease is common
- are present during an outbreak of the disease
- have some kinds of immune disorders. If the immune disorders are chronic, these kids also need a booster dose a few years later, depending on their age at the first dose.
The sequence and dosage depends on the child’s age, medical condition, and vaccine brand. Some types of meningococcal vaccines can be given as early as 8 weeks of age.
Kids 10 years and older with these risk factors also should get the MenB vaccine. They’ll need 2 or 3 doses depending on the brand. They might need more booster doses as long as the risk factor remains.
For those without risk factors, the decision to receive the MenB vaccine should be made together by teens, their parents, and the doctor. For them, the preferred age range is 1618 years. Usually, they need 2 doses.
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Can The Meningococcal Vaccine Cause Meningococcal Disease
The short answer is no. There are actually four meningococcal vaccines licensed in the U.S. None of the vaccines contains live bacteria.
The vaccines contain antigens — substances that trigger the body’s immune system and cause it to make antibodies. These antibodies then protect the body by attacking and killing the bacteria if it should invade your system.
The first vaccine — meningococcal polysaccharide vaccine or MPSV4 — was approved in 1978. It’s made with the antigens contained in the outer polysaccharide or sugar capsule that surrounds the bacterium.
The meningococcal conjugate vaccine or MCV4 was approved in 2005. It uses antigens taken from the polysaccharide capsule and then bound to a separate protein that targets the body’s immune cells. This makes it easier for the body’s immune system to see and recognize the antigens.
One type of MCV4, Menveo, is licensed for use in people ages 2 to 55. Another version, Menactra, is approved for those 9 months to 55 years old. MPSV4 is the only vaccine licensed for use in people over 55 as well as people 2 to 55. Both vaccines protect against four types of meningococcal disease.
Is It Possible To Get The Vaccine And Still Get Meningitis
Because the vaccines do not protect against all causes of meningitis, it is still possible that someone could receive the vaccine and still get meningitis from a different strain not protected by the vaccine. But the risk of contracting meningococcal meningitis is significantly lower after the vaccine.
There are other causes of meningitis that are preventable. Vaccines like the Hib vaccine and the pneumococcal vaccine are also very effective at protecting against other causes of meningitis and should be included as part of a routine childhood vaccination schedule. Check with your doctor and your children’s doctor to make sure that you and your family are protected against meningitis, as well as other serious illnesses.
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What Are The Risks Of The Meningococcal Vaccine
The most common problems are redness, warmth, swelling, or pain where the shot was given. You may feel tired, or you may get a headache, mild fever, or chills. You may also have muscle or joint pain, or nausea or diarrhea. These symptoms may last up to 7 days. Rarely, you may develop severe shoulder pain that lasts longer than 2 days. Also rarely, you may have a severe allergic reaction to the vaccine. This can be life-threatening.
Persons With Chronic Diseases
Asplenia
Two doses of Men-C-ACYW vaccine are recommended for persons with anatomic or functional asplenia, including sickle cell disease. When elective splenectomy is planned, all recommended vaccines should ideally be completed at least 2 weeks before surgery if only one dose can be given before surgery, the second dose should be given 8 weeks after the first dose, with a minimum interval of 4 weeks. In the case of an emergency splenectomy, two doses of vaccine should ideally be given beginning 2 weeks after surgery but can be given earlier, before discharge, if the person might not return for vaccination after discharge. Persons one year of age and older with asplenia who have not received Men-C-ACYW vaccine should receive two doses administered 8 weeks apart, with a minimum interval of 4 weeks. In addition, 4CMenB or MenB-fHBP vaccine should be offered. Periodic booster doses with Men-C-ACYW vaccine are also recommended.
Refer to Table 1 for vaccination recommendations of high risk individuals due to underlying conditions. Refer to Booster doses and re-immunization for additional information and Immunization of Persons with Chronic Diseases in Part 3 for additional general information.
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Common And Local Adverse Events
Conjugate meningococcal vaccines
Men-C-ACYW vaccines
Injection site reactions occur in up to 59% of vaccinees. Fever is reported in up to 5% of recipients and systemic reactions, such as headache and malaise, are reported in up to 60% of recipients.
Men-C-C vaccines
Mild reactions, including injection site reactions , occur in up to 50% of vaccine recipients. Irritability occurs in up to 80% of infants and fever in up to 9% when other vaccines were administered. Headaches and malaise occur in up to 10% of older children and adults. These reactions last no more than a few days.
Serogroup B Meningococcal vaccines
4CMenB vaccine
Solicited local and systemic reactions have been commonly reported in clinical trials and include injection site tenderness, induration, sleepiness and irritability. Higher rates of fever have been observed with simultaneous administration of 4CMenB vaccine and routine infant vaccines therefore, routine prophylactic administration of acetaminophen or separating 4CMenB vaccination from routine vaccination schedule has been proposed for preventing fever in infants and children up to three years of age.
MenB-fHBP vaccine
Solicited local and systemic reactions have been commonly reported in clinical trials and include injection site tenderness, induration and irritability.
Are Students Required To Get Meningococcal Vaccine Before College
Yes. Massachusetts law requires the following students receive quadrivalent meningococcal conjugate vaccine :
- Secondary School : newly enrolled full-time students who will be living in a dormitory or other congregate housing licensed or approved by the secondary school must provide documentation of having received a dose of meningococcal conjugate vaccine at any time in the past.
- Postsecondary Institutions : newly enrolled full-time students 21 years of age and younger must provide documentation of having received a dose of quadrivalent meningococcal conjugate vaccine on or after their 16th birthday, regardless of housing status.
Immunizations should be obtained prior to enrollment or registration however, students may be enrolled or registered provided that the required immunizations are obtained within 30 days of registration. There is no requirement for meningococcal B vaccination. However, adolescents and young adults may also be vaccinated with a serogroup B meningococcal vaccine, preferably at 16 through 18 years of age, to provide short term protection for most strains of serogroup B meningococcal disease.
More information about requirements and exemptions may be found in the MDPH document Information about Meningococcal Disease, Meningococcal Vaccines, Vaccination Requirements and the Waiver for Students at Colleges and Residential Schools.
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Why Are Meningococcal Vaccines Recommended
Meningococcal disease is caused by a type of bacteria. It can lead to an infection of the bloodstream or meningitis, or both, and can be life-threatening if not quickly treated. The MenACWY vaccine is very effective at protecting against four strains of the bacteria, while the MenB vaccine protects against a fifth strain.
What Are Meningococcal Quadrivalent Vaccines
Meningococcal quadrivalent vaccines protect against 4 types of meningococcal bacteria: types A, C, Y and W-135. The vaccines are either polysaccharide or conjugate vaccines. While both types of vaccines are approved by Health Canada, the conjugate vaccines are used in B.C. because they provide longer lasting protection against disease.
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Use Of Saliva Testing Of Antibody Levels Against Meningococcal Serogroups For Monitoring Meningococcal Vaccine Responses
The authors stated that a drawback of this study was that only samples of children aged 10 to 15years were used here to identify the salivary thresholds. Thus, these salivary thresholds as surrogate of protection have to be validated in other large meningococcal vaccine trials, preferably studies that include participants with a wide age range. furthermore, samples were collected only up to 1 year after vaccination. Whether saliva samples could be used as a surrogate of protection in the long-term after vaccination has to be examined as well.
Code Code Description
Submitting Proof Of Vaccination
Do not submit your vaccination proof to Undergraduate Admissions or the Student Health Center.
Texas State uses Magnus Health SMR for managing compliance with the meningitis vaccination requirement. New students planning to enroll at Texas State must submit proof of meningitis vaccination directly to Magnus Health SMR. Students subject to the bacterial meningitis requirement will receive an email from Magnus Health SMR with instructions. Students will be charged $10 by Magnus Health SMR for processing the documents and verifying compliance with the vaccination requirement. Acceptable evidence of vaccination may include any of the following:
- An official immunization record from a government health authority .
- An official immunization record received from school officials, including a record from another state .
- Students using a pharmacy should download and provide the pharmacist with the generic immunization form available on the Magnus website, once they have paid their processing fee, to ensure they receive an approvable document from the pharmacist . H-E-B customers should request their Vaccine Administration Consent Form for submission to Magnus.
- All records must be in English to be approved.
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Who Should Receive A Meningitis Vaccine
Meningitis vaccination is recommended for individuals over 11-years-old. This includes both the A, C, W and Y immunization and the B vaccination.
Travellers or others who could be exposed to meningitis should also be vaccinated this includes:
- Travellers to the meningitis belt in Africa
- Travellers going to Hajj in Saudi Arabia
- Individuals who work in confined conditions
- Healthcare workers
- College or other students
If you have not been vaccinated, or are unsure of your vaccination history, Passport Health can help. We keep meningitis vaccinations in-stock and ready for your trip or need. Call to schedule your appointment or book online now.
Who Should Get The Meningococcal Quadrivalent Conjugate Vaccine
The vaccine is provided free to children in grade 9.
The vaccine is also provided free to children and adults at high risk of meningococcal disease, including those who have:
- no spleen, or a spleen that is not working properly
- immune system disorders including complement, properdin or factor D deficiencies, or primary antibody deficiency
- an islet cell or solid organ transplant, or those who are waiting for one
- had a stem cell transplant
- been in close contact with a person with meningococcal A, Y or W-135 disease, or who are determined by public health to be at risk of infection with these during an outbreak in B.C.
The vaccine is recommended, but not provided free, for the following people:
- laboratory workers routinely exposed to meningococcal bacteria
- military personnel and
- those living or travelling in a high risk area for meningococcal disease.
For information on high risk travel areas contact a travel clinic.
The vaccine is usually given as 1 dose. Some people may need additional doses of the vaccine. Speak with your health care provider to find out if you need additional doses and when you should get them.
People who are not eligible for the free vaccine but want to be protected against meningococcal A, C, Y and W-135 strains of the disease can purchase the quadrivalent vaccine at most travel clinics and pharmacies.
It is important to keep a record of all immunizations received.
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