** La última columna hace referencia a versiones anteriores.


CPT  CODE
CPT DESCRIPTION

CVX CODE

VACCINE NAME

EHREZ

(Versiones anteriores)

90281
Immune globulin (IG), human, for intramuscular use.

86

IG
 
90283

Immune globulin (IGIV), human, for intravenous use...

87

IGIV
 
90287
Botulinum antitoxin, equine, any route
27
botulinum antitoxin

 

90291
Cytomegalovirus immune globulin (CMV-IGIV), human, for intravenous use.
29
CMVIG
 
90296
Diphtheria antitoxin, equine, any route
12
diphtheria antitoxin
 
90371
Hepatitis B immune globulin (HBIG), human, for intramuscular use
30
HBIG
 
90375
Rabies immune globulin (RIG), human, for intramuscular and/or subcutaneous use
34
RIG
 
90376
Rabies immune globulin, heat-treated (RIG-HT), human, for intramuscular and/or subcutaneous use
34
RIG
 
90378
Respiratory syncytial virus immune globulin (RSV-IgIM), for intramuscular use, 50 mg, each
93

RSV-MAb

 
90379
Respiratory syncytial virus immune globulin (RSV-IGIV), human, for intravenous use
71
RSV-IGIV
 
90389
Tetanus immune globulin (TIG), human, for intramuscular use
13
TIG

 

90393
Vaccinia immune globulin, human, for intramuscular use
79
vaccinia immune globulin
 
90396
Varicella-zoster immune globulin, human, for intramuscular use
36
VZIG
 
90470
H1N1 immunization administration (intramuscular, intranasal), including counseling when performed
128
Novel Influenza-H1N1-09, all formulations
 
90476
Adenovirus vaccine, type 4, live, for oral use
54
adenovirus, type 4
 
90477
Adenovirus vaccine, type 7, live, for oral use
55
adenovirus, type 7
 
90581
Anthrax vaccine, for subcutaneous use
24
anthrax
 
90585
Bacillus Calmette-Guerin vaccine (BCG) for tuberculosis, live, for percutaneous use
19
BCG
 
90632
Hepatitis A vaccine, adult dosage, for intramuscular use
52
Hep A, adult
 
90633
Hepatitis A vaccine, pediatric/adolescent dosage-2 dose schedule, for intramuscular use
83
Hep A, ped/adol, 2 dose

HEP A


Se administrará a todo niño de 1 año de edad. Requiere una segunda dosis a los 6 meses luego de la primera dosis.

90634
Hepatitis A vaccine, pediatric/adolescent dosage-3 dose schedule, for intramuscular use
84
Hep A, ped/adol, 3 dose
 
90636
Hepatitis A and hepatitis B (HepA-HepB), adult dosage, for intramuscular use
104
Hep A-Hep B
 
90644
Meningococcal conjugate vaccine, serogroups C & Y and Hemophilus influenza B vaccine (Hib-MenCY), 4 dose schedule, when administered to children 2-15 months, for intramuscular use
148
Meningococcal C/Y-HIB PRP
 
90645
Haemophilus influenza b vaccine (Hib), HbOC conjugate (4 dose schedule), for intramuscular use
47
Hib (HbOC)
HIB

 

Se administrará a todo niño de 2 a 59 meses a los 2, 4, 6 y 15 meses de edad.
90646
Haemophilus influenza b vaccine (Hib), PRP-D conjugate, for booster use only, intramuscular use
46
Hib (PRP-D)

 

90647
Haemophilus influenza b vaccine (Hib), PRP-OMP conjugate (3 dose schedule), for intramuscular use
49
Hib (PRP-OMP)
 
90648
Haemophilus influenza b vaccine (Hib), PRP-T conjugate (4 dose schedule), for intramuscular use
48
Hib (PRP-T)
 
90649
Human Papilloma virus (HPV) vaccine, types 6, 11, 16, 18 (quadrivalent) 3 dose schedule, for intramuscular use
62
HPV, quadrivalent

GARDASIL

 
 

SE ADMINISTRA A LOS 11 A 18 AÑOS. SE REQUIEREN TRES DOSIS EN EL ESQUEMA 0 A LOS 2 MESES Y A LOS 6 MESES.

90650
Human Papilloma virus (HPV) vaccine, types 16, 18, bivalent, 3 dose schedule, for intramuscular use
118
HPV, bivalent
CERVARIX
 
 
 
SE ADMINISTRA A LAS FEMINAS DE 11 A 18 AÑOS DE EDAD. SE REQUIEREN 3 DOSIS 0 A LOS 2 MESES Y A LOS 6 MESES.
90654
Influenza virus vaccine, split virus, preservative free, for intradermal use
144
influenza, seasonal, intradermal, preservative free
 
90655
Influenza virus vaccine, split virus, preservative free, for children 6-35 months of age, for intramuscular use. 
140
Influenza, seasonal, injectable, preservative free
INFLUENZA
 
 

SE ADMINISTRA ANUALMENTE A TODO NIÑO 6 MESES A 35 MESES DE EDAD.

90656
Influenza virus vaccine, split virus, preservative free, for use in individuals 3 years of age and above, for intramuscular use
140
Influenza, seasonal, injectable, preservative free
 
90657
Influenza virus vaccine, split virus, for children 6-35 months of age, for intramuscular use. 
141
Influenza, seasonal, injectable. 
INFLUENZA
 
 
 

90658
Influenza virus vaccine, split virus, for use in individuals 3 years of age and above, for intramuscular use
141
Influenza, seasonal, injectable
 
90659
Influenza virus vaccine, whole virus, for intramuscular or jet injection use
16
influenza, whole
 
90660
Influenza virus vaccine, live, for intranasal use
111
influenza, live, intranasal
 
90661
Influenza virus vaccine, derived from cell cultures, subunit, preservative and antibiotic free, for intramuscular use
153
Influenza, injectable, MDCK, preservative free


90662
Influenza virus vaccine, split virus, preservative free, enhanced immunogenicity via increased antigen content, for intramuscular use
135
Influenza, high dose seasonal
 
90663
Influenza virus vaccine, pandemic formulation, H1N1
128
Novel Influenza-H1N1-09, all formulations
 
90664
Influenza virus vaccine, pandemic formulation, live, for intranasal use
125
Novel Influenza-H1N1-09, nasal
 
90665
Lyme disease vaccine, adult dosage, for intramuscular use
66
Lyme disease
 
90666
Influenza virus vaccine, pandemic formulation, split-virus, preservative free, for intramuscular use
126
Novel influenza-H1N1-09, preservative-free
 
90668
Influenza virus vaccine, pandemic formulation, split-virus, for intramuscular use
127
Novel influenza-H1N1-09
 
90669
Pneumococcal conjugate vaccine, polyvalent, for children under five years, for intramuscular use
100
pneumococcal conjugate PCV 7
 
90670
Pneumococcal conjugate vaccine, 13 valent, for intramuscular use. 
133
Pneumococcal conjugate PCV 13
PCV
 
 

 


SE ADMINISTRARA PCV13 A TODO NIÑO DE 2 A 59 MESES DE EDAD(COMENZANDO A LOS 2,4,6 Y 15 MESES DE EDAD).

90672
Influenza virus vaccine, quadrivalent, live, for intranasal use
149
influenza, live, intranasal, quadrivalent
 
90673
Influenza virus vaccine, trivalent, derived from recombinant DNA (RIV3), hemagglutnin (HA) protein only, preservative and antibiotic free, for intramuscular use
155
influenza, recombinant, injectable, preservative free
 
90675
Rabies vaccine, for intramuscular use
18
rabies, intramuscular injection
 
90676
Rabies vaccine, for intradermal use
40
rabies, intradermal injection
 
90680
Rotavirus vaccine, pentavalent, 3 dose schedule, live, for oral use. 
116
Rotavirus, pentavalent
ROTATEQ
 
 
 
SE ADMINISTRARA LA 1ra DOSIS A LOS 2 MESES. EDAD MINIMA PARA LA PRIMERA DOSIS ES 6 SEMANAS, EDAD MAXIMA PARA ESTA PRIMERA DOSIS ES 14 SEMANAS DE NACIDO. LA 3ra DOSIS NO PUEDE SER ADMINISTRADA DESPUES DE LAS 32 SEMANAS DE NACIDO.
90681
Rotavirus vaccine, human, attenuated, 2 dose schedule, live, for oral use. 
119
Rotavirus, monovalent
ROTAVIRIX
 
 

SE ADMINSTRA LA 1ra DOSIS A LOS 2 MESES. EDAD MINIMA PARA LA PRIMERA DOSIS ES 6 SEMANAS, EDAD MAXIMA PARA ESTA PRIMERA DOSIS ES 14 SEMANAS DE NACIDO. LA 3ra DOSIS NO PUEDE SER ADMINISTRADA DESPUES DE LAS 32 SEMANAS DE NACIDO.

90685
Influenza virus vaccine, quadrivalent, split virus, preservative free, when administered to children 6-35 months of age, for intramuscular us
150
influenza, injectable, quadrivalent, preservative free
 
90686
Influenza virus vaccine, quadrivalent, split virus, preservative free, when administered to individuals 3 years of age and older, for intramuscular use
150
influenza, injectable, quadrivalent, preservative free
 
90688
Influenza virus vaccine, quadrivalent, split virus, when administered to individuals 3 years of age and older, for intramuscular use
158
influenza, injectable, quadrivalent
 
90690
Typhoid vaccine, live, oral
25
typhoid, oral
 
90691
Typhoid vaccine, Vi capsular polysaccharide (ViCPs), for intramuscular use
101
typhoid, ViCPs
 
90692
Typhoid vaccine, heat- and phenol-inactivated (H-P), for subcutaneous or intradermal use
41
typhoid, parenteral
 
90693
Typhoid vaccine, acetone-killed, dried (AKD), for subcutaneous use (U.S. military)
53
typhoid, parenteral, AKD (U.S. military)
 
90696
Diphtheria, tetanus toxoids, acellular pertussis vaccine and poliovirus vaccine, inactivated (DTaP-IPV), when administered to children 4 years through 6 years of age, for intramuscular use. 
130
DTaP-IPV
KINRIX
 
 
 

SE ADMINISTRA SOLO A LOS 4 AÑOS DE EDAD.

90698
Diphtheria, tetanus toxoids, and acellular pertussis vaccine, haemophilus influenza Type B, and poliovirus vaccine, inactivated (DTaP - Hib - IPV), for intramuscular use. 
120

DTaP-Hib-IPV
PENTACEL

 

 

SE ADMINISTRA LOS PRIMEROS MESES DEL PACIENTE DE ACUERDO AL PROTOCOLO 2,4,6 MESES DE EDAD.

90700
Diphtheria, tetanus toxoids, and acellular pertussis vaccine (DTaP), for use in individuals younger than seven years, for intramuscular use. 
20

DTaP

Dtap/Dta[/DT
 

 

SE RECOMIENDA SERIE PRIMARIA 2,4,6 MESES DE EDAD, 4ta DOSIS A LOS 15 MESES Y LA QUINTA Y ULTIMA DOSIS A LOS 4 AÑOS DE EDAD.
90700
Diphtheria, tetanus toxoids, and acellular pertussis vaccine (DTaP), for use in individuals younger than seven years, for intramuscular use. 
106
DTaP, 5 pertussis antigens
 
90701
Diphtheria, tetanus toxoids, and whole cell pertussis vaccine (DTP), for intramuscular use
01
DTP
 
90702
Diphtheria and tetanus toxoids (DT) adsorbed for use in individuals younger than seven years, for intramuscular use
28
DT (pediatric)
 
90703
Tetanus toxoid adsorbed, for intramuscular use
35
tetanus toxoid, adsorbed
 
90704
Mumps virus vaccine, live, for subcutaneous use
07
mumps
 
90705
Measles virus vaccine, live, for subcutaneous use
05
measles
 
90706
Rubella virus vaccine, live, for subcutaneous use
06
rubella
 
90707
Measles, mumps and rubella virus vaccine (MMR), live, for subcutaneous use. 
03
MMR
MMR
 

 

SE RECOMIENDA UNA PRIMERA DOSIS A LOS 12 MESES Y UNA SEGUNDA DOSIS A LOS 4 AÑOS DE EDAD.
90708
Measles and rubella virus vaccine, live, for subcutaneous use
04
M/R
 
90710
Measles, mumps, rubella, and varicella vaccine (MMRV), live, for subcutaneous use
94
MMRV
 
90712
Poliovirus vaccine, (any type(s)) (OPV), live, for oral use.
02
OPV
 
90713
Poliovirus vaccine, inactivated, (IPV), for subcutaneous or intramuscular use.
10
IPV
IVP
 
 
LA SERIE PRIMARIA SE ADMINISTRA A LOS 2,4,6 MESES DE EDAD. LA CUARTA DOSIS DEBE SER ADMINISTRADA EN O DESPUES DE CUMPLIR LOS 4 AÑOS.
90714
Tetanus and diphtheria toxoids (Td) adsorbed, preservative free, for use in individuals seven years or older, for intramuscular use. 
113
TD (adult) preservative free
TD
 
 
VACUNA DE REFUERSO CADA 10 AÑOS DE EDAD.
90714
Typhoid vaccine
91
typhoid, unspecified formulation
 
90715
Tetanus, diphtheria toxoids and acellular pertussis vaccine (Tdap), for use in individuals 7 years or older, for intramuscular use. 
115
TDAP
TDAP
 
 
SE ADMINISTRA A LOS 11 AÑOS DE EDAD. SE RECOMIENDA VACUNAR CON TdaP A LOS ADOLESCENTES DE 12 A 18 AÑOS QUE NO HAN RECIBIDO TdaP. Luego de administrar Td casa 10 AÑOS.
90716
Varicella virus vaccine, live, for subcutaneous use
21

Varicella
VARICELA
 

SE LE ADMINISTRARA LA PRIMERA DOSIS AL 1er AÑO DE EDAD Y LA PROXIMA A LOS 4 AÑOS DE EDAD. SE RECOMIENDA UN INTERVALO MINIMO DE 3 MESES ENTRE AMBAS DOSIS PARA LOS MENORES DE 13 AÑOS DE EDAD Y DE 30 DIAS PARA AQUELLOS DE 13 AÑOS O MAYORES

90717
Yellow fever vaccine, live, for subcutaneous use
37
yellow fever
 
90718
Tetanus and diphtheria toxoids (Td) adsorbed for use in individuals seven years or older, for intramuscular use
09
Td (adult), adsorbed
 
90720
Diphtheria, tetanus toxoids, and whole cell pertussis vaccine and Hemophilus influenza B vaccine (DTP-Hib), for intramuscular use
22
DTP-Hib
 
90721
Diphtheria, tetanus toxoids, and acellular pertussis vaccine and Hemophilus influenza B vaccine (DTaP-Hib), for intramuscular use
50
DTaP-Hib
 
90723

Diphtheria, tetanus toxoids, acellular pertussis vaccine, Hepatitis B, and poliovirus vaccine, inactivated (DTaP-HepB-IPV), for intramuscular use. 

110
DTaP-Hep B-IPV
PEDIATRIX
 
 
SE ADMINISTRA A LOS 2 Y 6 MESES SI LE ADMINISTRARON AL NACER LA HEP. B EN EL HOSPITAL. SI NO LE ADMINISTRARON EN HOSPITAL LA PRIMERA HEP. B ENTONCES SE ADMINISTRA 2,4, 6 MESES DE EDAD.
90724
Influenza virus vaccine
88
influenza, unspecified formulation
 
90725
Cholera vaccine for injectable use
26
cholera
 
90726
Rabies vaccine
90
rabies, unspecified formulation
 
90727
Plague vaccine, for intramuscular use
23
plague
 
90728
BCG vaccine
19
BCG
 
90730
Hepatitis A vaccine
85
Hep A, unspecified formulation
 
90731
Hepatitis B vaccine
45
Hep B, unspecified formulation
 
90732
Pneumococcal polysaccharide vaccine, 23-valent, adult or immunosuppressed patient dosage, for use in individuals 2 years or older, for subcutaneous or intramuscular use.
33
Pneumococcal Polysaccharide PPV23
PENUMOVAX 23
 
 
 

SE ADMINISTRA A PACIENTES CON CONDICIONES SEVERAS DE PNEUMONIA. DE ACUERDO AL PROTOCOLO INDICADO.

90733
Meningococcal polysaccharide vaccine (any group(s)), for subcutaneous use
32
meningococcal MPSV4
 
90734
Meningococcal conjugate vaccine, serogroups A, C, Y and W-135 (tetravalent), for intramuscular use.
136
Meningococcal MCV4O
MCV

 

 
SE ADMINISTRA A TODO ADOLESCENTE DE 11 A 18 AÑOS CON UNA PRIMERA DOSIS A LOS 11 AÑOS Y UN REFUERZO A LOS 16 AÑOS.
90734
Meningococcal conjugate vaccine, serogroups A, C, Y and W-135 (tetravalent), for intramuscular use.
114
meningococcal MCV4P
 
90735
Japanese encephalitis virus vaccine, for subcutaneous use
39
Japanese encephalitis SC
 
90736
Zoster (shingles) vaccine, live, for subcutaneous injection
121
Zoster

ZOSTER VACC SC
90737

Hemophilus influenza B

17
Hib, unspecified formulation
 
90738
Japanese encephalitis virus vaccine, inactivated, for intramuscular use
134
Japanese Encephalitis IM
 
90740
Hepatitis B vaccine, dialysis or immunosuppressed patient dosage (3 dose schedule), for intramuscular use
44
Hep B, dialysis
 
90741
Immunization, passive; immune serum globulin, human (ISG)
14
IG, unspecified formulation
 
90743
Hepatitis B vaccine, adolescent (2 dose schedule), for intramuscular use
43
Hep B, adult
 
90744
Hepatitis B vaccine, pediatric/adolescent dosage (3 dose schedule), for intramuscular use. 
08
Hep B, adolescent or pediatric
HEPB VACC PED / ADOL 3 DOSE IN
 
 
Or
 
HEP B

 


SE ADMINISTRARA LA PRIMERA DOSIS A TODO NIÑO AL NACER, PREVIO A SER DE ALTA DEL HOSPITAL. SE DEBERA COMPLETAR EL ESQUEMA 0, 2, 6 MESES DE EDAD. SI NO SE LE ADMINISTRO AL NACER ENTONCES SE LE ADMINISTRARA A LOS 2,4,6 MESES DE EDAD.


90745
Hepatitis B vaccine, adolescent/high risk infant dosage, for intramuscular use
42
Hep B, adolescent/high risk infant
 
90746
Hepatitis B vaccine, adult dosage, for intramuscular use
43
Hep B, adult
 
90747
Hepatitis B vaccine, dialysis or immunosuppressed patient dosage (4 dose schedule), for intramuscular use
44
Hep B, dialysis
 
90748
Hepatitis B and Hemophilus influenza b vaccine (HepB-Hib), for intramuscular use
51
Hib-Hep B