FY 2017 MDHHS Deliverable Submission Form Name of Project: Michigan Care Improvement Registry Support Project Document Name: Supported Vaccine Codes Project Number: J-64274 Program Name: Center for Social Enterprise Director or Coordinator Name: Jeff Allison Submitted By: Karen McGettigan Type of Deliverable: (Please check one) Final report Specialized report Publication Articles published Brochures Software application Web screen shot No report, publication, or study Deliverable pending OTHER material If OTHER, please describe: Supported Vaccine Codes is updated as new code information is available. https://www.mcir.org/wp-content/uploads/2014/09/All_Vaccine_codes.pdf
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FY 2017 MDHHS Deliverable Submission Form - … 2017 MDHHS Deliverable Submission Form . ... 3 dose 90740 Merck MSD Engergix-B-DIALYSIS Hepatitis B (dialysis) ... 84 HepA ped/adol,
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FY 2017 MDHHS Deliverable Submission Form
Name of Project: Michigan Care Improvement Registry Support Project
Document Name: Supported Vaccine Codes
Project Number: J-64274
Program Name: Center for Social Enterprise
Director or
Coordinator Name:
Jeff Allison
Submitted By: Karen McGettigan
Type of Deliverable: (Please check one)
Final report
Specialized report
Publication
Articles published
Brochures
Software application
Web screen shot
No report, publication, or study
Deliverable pending
OTHER material If OTHER, please describe:
Supported Vaccine Codes is updated as new code information is available.
Supported MCIR Vaccine Codes Including U.S. Licensed CVX, CPT-4, and MVX MCIR codes are a reflection, but not a complete list of, those maintained at the CDC National Immunization Program
*Bold = Updated or New Information MCIR codes are a reflection, but not a complete list of, those maintained at the CDC National Immunization Program website:http://www2a.cdc.gov/vaccines/IIS/IISStandards/vaccines.asp?rpt=cvx MCIR Helpdesk at MPHI Page 1 07-20-2017
CDC Vaccine Code (CVX)
MCIR Vaccine Display Name
CDC Product Name CDC Vaccine Name
CDC Current Procedural Terminology Code (CPT Code)
VAQTA-PEDS Hepatitis A pediatric (HepA) 90633 Merck MSD
104 HepA-HepB (Twinrix) TWINRIX Hepatitis A-Hepatitis B (HepA-HepB)
90636 GlaxoSmithKline SKB
43 HepB (adult) RECOMBIVAX-ADULT
Hepatitis B adult (HepB) 90746 Merck MSD
43 HepB (adult) RECOMBIVAX-ADULT
Hepatitis B adolescent (2 dose) 90743 Merck MSD
43 Hep B (adult) ENGERIX-B-ADULT Hepatitis-B adult (HepB) 90746 GlaxoSmithKline SKB
44 HepB (dialysis)
RECOMBIVAX-DIALYSIS
Hepatitis B (dialysis) 3 dose 90740 Merck MSD
Engergix-B-DIALYSIS Hepatitis B (dialysis) 4 dose 90747 GlaxoSmithKline
SKB
Supported MCIR Vaccine Codes Including U.S. Licensed CVX, CPT-4, and MVX MCIR codes are a reflection, but not a complete list of, those maintained at the CDC National Immunization Program
*Bold = Updated or New Information MCIR codes are a reflection, but not a complete list of, those maintained at the CDC National Immunization Program website:http://www2a.cdc.gov/vaccines/IIS/IISStandards/vaccines.asp?rpt=cvx MCIR Helpdesk at MPHI Page 2 07-20-2017
CDC Vaccine Code (CVX)
MCIR Vaccine Display Name
CDC Product Name CDC Vaccine Name
CDC Current Procedural Terminology Code (CPT Code)
MANUFACTURER
Manufacturer Code (MVX)
08 HepB (ped/adol) ENGERIX B-PEDS Hepatitis B pediatric or adolescent 90744 GlaxoSmithKline SKB
RECOMBIVAX-PEDS Hepatitis B pediatric or adolescent 90744 Merck MSD
48 Hib (ActHib/Hiberix) ACTHIB
Haemophilus influenzae type b (Hib)
90648 Sanofi (ActHIB) PMC
HIBERIX Haemophilus influenzae type b (Hib)
90648 Glaxo (HIBERIX) SKB
49 Hib (PedvaxHIB) PEDVAXHIB Haemophilus influenzae type b (Hib)(3dose)
Supported MCIR Vaccine Codes Including U.S. Licensed CVX, CPT-4, and MVX MCIR codes are a reflection, but not a complete list of, those maintained at the CDC National Immunization Program
*Bold = Updated or New Information MCIR codes are a reflection, but not a complete list of, those maintained at the CDC National Immunization Program website:http://www2a.cdc.gov/vaccines/IIS/IISStandards/vaccines.asp?rpt=cvx MCIR Helpdesk at MPHI Page 3 07-20-2017
CDC Vaccine Code (CVX)
MCIR Vaccine Display Name
CDC Product Name CDC Vaccine Name
CDC Current Procedural Terminology Code (CPT Code)
Trumenba Meningococcal B vaccine, fully recombinant
90621 Pfizer PFR
163 Meningococcal B, OMV
Bexsero Meningococcal B vaccine, recombinant, OMV, adjuvanted
90620 GlaxoSmithKline SKB
Supported MCIR Vaccine Codes Including U.S. Licensed CVX, CPT-4, and MVX MCIR codes are a reflection, but not a complete list of, those maintained at the CDC National Immunization Program
*Bold = Updated or New Information MCIR codes are a reflection, but not a complete list of, those maintained at the CDC National Immunization Program website:http://www2a.cdc.gov/vaccines/IIS/IISStandards/vaccines.asp?rpt=cvx MCIR Helpdesk at MPHI Page 4 07-20-2017
CDC Vaccine Code (CVX)
MCIR Vaccine Display Name
CDC Product Name CDC Vaccine Name
CDC Current Procedural Terminology Code (CPT Code)
Supported MCIR Vaccine Codes Including U.S. Licensed CVX, CPT-4, and MVX MCIR codes are a reflection, but not a complete list of, those maintained at the CDC National Immunization Program
*Bold = Updated or New Information MCIR codes are a reflection, but not a complete list of, those maintained at the CDC National Immunization Program website:http://www2a.cdc.gov/vaccines/IIS/IISStandards/vaccines.asp?rpt=cvx MCIR Helpdesk at MPHI Page 5 07-20-2017
CDC Vaccine Code (CVX)
MCIR Vaccine Display Name
CDC Product Name CDC Vaccine Name
CDC Current Procedural Terminology Code (CPT Code)
Supported MCIR Vaccine Codes Inactive and Unspecified
*Bold = Updated or New Information MCIR codes are a reflection, but not a complete list of, those maintained at the CDC National Immunization Program website:http://www2a.cdc.gov/vaccines/IIS/IISStandards/vaccines.asp?rpt=cvx MCIR Helpdesk at MPHI Page 6 07-20-2017
Vaccine Code (CVX)
MCIR DISPLAY Inactive/ Unspecified
VACCINE NAME
CDC Current Procedural Terminology Code (CPT-4)
26 Cholera Inactive Cholera 90725
51 Comvax (Hib-HepB) Inactive Haemophilus influenzae type b-Hepatitis B (Hib-HepB)
90748
107 DTaP (unspecified) Unspecified Diphtheria, tetanus toxoids and acellular
pertussis vaccine, unspecified
formulation
01 DTP Inactive Diphtheria, tetanus toxoids and pertussis vaccine
Supported MCIR Vaccine Codes Inactive and Unspecified
*Bold = Updated or New Information MCIR codes are a reflection, but not a complete list of, those maintained at the CDC National Immunization Program website:http://www2a.cdc.gov/vaccines/IIS/IISStandards/vaccines.asp?rpt=cvx MCIR Helpdesk at MPHI Page 7 07-20-2017