Purpose
The purpose of this communication is to clarify the Company's coverage position for our Commercial members regarding meningococcal (Groups A, C, W, and Y) conjugate vaccines, which is retroactively effective to November 18, 2024.
Background
Meningococcal disease can lead to serious sequelae (a condition caused by previous disease), including deafness, neurologic deficit, limb loss, or possibly death. Meningococcal (Groups A, C, W, and Y) conjugate vaccines provide protection against invasive meningococcal disease. One of these vaccines is Menactra (MenACWY-D). The manufacturer of Menactra discontinued production of this vaccine, and, therefore, it is no longer distributed in the United States. In October 2023, the last dose of the meningococcal polysaccharide diphtheria toxoid conjugate, Menactra (MenACWY-D) vaccine expired.
Another meningococcal (Groups A, C, W, and Y) conjugate vaccine, Menveo MenACWY-CRM, remains on the market in the United States.
Coverage Statement
Menveo (MenACWY-CRM), a meningococcal (Groups A, C, Y, and W-135) oligosaccharide diphtheria CRM197 conjugate vaccine, should be reported with procedure code 90734. (Note: Menactra (MenACWY-D), which is no longer available, had also been reported with procedure code 90734 when it was on the market.)
Coding
THE FOLLOWING CODE REPRESENTS MENVEO (MenACWY-CRM)
90734
THE FOLLOWING CODE REPRESENTS MENACTRA (MenACWY-D), WHICH IS NO LONGER MANUFACTURED AND HAS BEEN WITHDRAWN FROM THE MARKET
90734
