2019 Vaccine Guide & Insert - 22

PNEUMOCOCCAL
Pneumococcal
What causes pneumococcal disease?
Pneumococcal disease is caused by Streptococcus pneumoniae, a bacterium that has more than
90 serotypes. Most serotypes cause disease, but only a few produce the majority of invasive
pneumococcal disease. The 10 most common types cause 62% of invasive disease worldwide.
How serious is pneumococcal disease in the U.S.?
Pneumococcal disease is a serious disease that causes much sickness and death. An estimated
30,400 cases and 3,690 deaths from invasive pneumococcal diseases (IPD-bacteremia and
-meningitis) occurred in the United States in 2016 (see www.cdc.gov/abcs/reports-findings/
survreports/spneu16.html). Young children and the elderly (younger than age two years and older
than 50) have the highest incidence of serious disease.
Case-fatality rates are highest for pneumococcal meningitis and bacteremia, and the highest
mortality occurs among the elderly and patients who have underlying medical conditions. Despite
appropriate antimicrobial therapy and intensive medical care, the overall case-fatality rate for
pneumococcal bacteremia is about 15% among adults. Among elderly patients, this rate may
be as high as 60%.

All infants should be
given a primary series
of PCV13, at ages 2,
4, and 6 months with
a booster at age 12 to
15 months. Children
who fall behind should
be given catch-up
vaccination through
age 59 months, if
otherwise healthy
or, through age 71
months if they have
certain underlying
medical conditions.

Which adults are now recommended to receive a dose of PCV13?
According to the ACIP recommendations published in September 2014, both pneumococcal
conjugate vaccine (PCV13) and pneumococcal polysaccharide vaccine (PPSV23) should be
administered routinely in a series to all adults age 65 years and older. The two vaccines should
not be given at the same visit.
In addition to adults age 65 years and older, adults age 19 through 64 years who have the
conditions specified below and who have not previously received PCV13 should receive a
PCV13 dose during their next vaccination opportunity.
* Immunocompromising conditions (e.g., congenital or acquired immunodeficiency, HIV, chronic
renal failure, nephrotic syndrome, leukemia, lymphoma, Hodgkin disease, generalized
malignancy, immunosuppression by corticosteroids or chemotherapy, solid organ transplant,
and multiple myeloma)
* Functional or anatomic asplenia (e.g., sickle cell disease and other hemoglobinopathies
and congenital and acquired asplenia)
* Cerebrospinal fluid (CSF) leak
* Cochlear implant
Source: http://www.immunize.org/askexperts/experts_pneumococcal_vaccines.asp
CPT Information
Administration CPT Code without
physician counseling

90471, 90472, 90473 or 90474

Administration CPT Code with
physician counseling

90460 or 90461

PNEUMOVAX®23

90732

PREVNAR 13®

90670

For informational purposes only. Source: ReimbursementCodes.com and/or www.cms.gov. Customer is responsible for verification of billing/coding in accordance with applicable specific circumstances.
See manufacturer package insert for full prescribing information.
†

To Order: 1.800.P.SCHEIN (1.800.772.4346) 8am-8:30pm, et

To Fax: 1.800.329.9109 24 Hrs

19MS4037

https://www.cdc.gov/abcs/reports-findings/survreports/spneu16.html https://www.cdc.gov/abcs/reports-findings/survreports/spneu16.html http://www.immunize.org/askexperts/experts_pneumococcal_vaccines.asp http://www.ReimbursementCodes.com http://www.cms.gov

2019 Vaccine Guide & Insert

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