CPT® Code 90371

1. Indications

The administration of Hepatitis B immune globulin (HBIg) is indicated for specific clinical scenarios where immediate passive immunity is required to protect against hepatitis B infection. The following conditions warrant the use of HBIg:

• Post-exposure prophylaxis for individuals who have been exposed to hepatitis B virus, particularly in cases of needlestick injuries or sexual exposure to an infected individual.
• Prevention of hepatitis B infection in newborns born to mothers who are hepatitis B surface antigen (HBsAg) positive, ensuring that the infant receives immediate protection against the virus.
• Immunocompromised patients who may not respond adequately to hepatitis B vaccination and require additional protection against potential exposure to the virus.

2. Procedure

The procedure for administering Hepatitis B immune globulin (HBIg) involves several key steps to ensure safe and effective delivery of the immunizing agent. The following procedural steps are outlined:

• Step 1: Patient Assessment - Prior to administration, a thorough assessment of the patient’s medical history and potential exposure to hepatitis B virus is conducted. This includes evaluating the need for passive immunity based on the indications for HBIg use.
• Step 2: Preparation of the HBIg - The HBIg solution is prepared according to the manufacturer's instructions. This may involve checking the expiration date, ensuring the integrity of the packaging, and drawing the appropriate dosage into a syringe while maintaining aseptic technique.
• Step 3: Administration - The HBIg is administered via intramuscular injection, typically into the deltoid muscle for adults or the anterolateral thigh for infants. The injection site is cleaned with an antiseptic wipe to minimize the risk of infection, and the injection is performed using a sterile needle and syringe.
• Step 4: Post-Administration Monitoring - After the injection, the patient is monitored for any immediate adverse reactions or side effects. This includes observing for signs of allergic reactions or local reactions at the injection site.

3. Post-Procedure

Following the administration of Hepatitis B immune globulin (HBIg), patients are typically advised to remain under observation for a short period to ensure there are no immediate adverse reactions. It is important to provide the patient with information regarding potential side effects, which may include mild pain or swelling at the injection site, fever, or allergic reactions. Patients should also be informed about the importance of follow-up care, especially if they are at risk for hepatitis B infection, and the need for additional vaccinations or treatments as recommended by their healthcare provider. Documentation of the administration, including the lot number of the HBIg, dosage, and injection site, should be recorded in the patient's medical record for future reference and compliance purposes.