Human Papillomavirus (HPV) Vaccine (CPB 0726, reviewed 2025-11-25)

By 2025-11-25: Billing team must immediately update billing system to deny or reject claims using CPT 90649 (quadrivalent Gardasil) and CPT 90650 (Cervarix) for Aetna commercial plans. Configure system to ONLY allow CPT 90651 (Gardasil 9) for HPV vaccination claims for members ages 9-45. Front desk staff must update patient intake forms and scheduling systems to reflect that only Gardasil 9 is covered. Providers must document in clinical records if transitioning from older HPV vaccines to Gardasil 9, as continuation/completion of series may be covered per policy language. Any claims submitted for CPT 90649 or 90650 without documented transition reason will be denied. Do NOT bill for any of the excluded ICD-10 diagnoses listed (A63.0, C51-C53, D06-D07, D10, D14.1, K62.82, N87) as these indicate non-covered uses per experimental/investigational language. Update encounter templates to remove references to older HPV vaccines.