How To Use CPT Code 90674

CPT 90674 refers to the supply of a specific type of influenza virus vaccine, and this article will discuss its description, procedure, qualifying circumstances, usage, documentation requirements, billing guidelines, historical information, similar codes, and examples.

1. What is CPT 90674?

CPT 90674 is a code used to represent the supply of a specific type of influenza virus vaccine, known as the quadrivalent cell culture-derived influenza virus vaccine. This vaccine is designed to protect against four different strains of the influenza virus and is administered intramuscularly in a 0.5 mL dosage. The vaccine is preservative and antibiotic-free, making it suitable for individuals with certain allergies or sensitivities.

2. 90674 CPT code description

The official description of CPT code 90674 is: “Influenza virus vaccine, quadrivalent (ccIIV4), derived from cell cultures, subunit, preservative and antibiotic free, 0.5 mL dosage, for intramuscular use.”

3. Procedure

1. The healthcare provider discusses the available immunization options with the patient, guardian, or parent, reviewing the risks, benefits, and potential side effects of each option.
2. The provider selects the appropriate vaccine based on the patient’s age, medical history, and other factors.
3. The provider prepares the 0.5 mL dosage of the quadrivalent cell culture-derived influenza virus vaccine (such as Flucelvax® Quadrivalent).
4. The vaccine is administered via intramuscular injection, typically in the upper arm or thigh.
5. The provider documents the vaccine administration, including the product used, administration route, and purpose.

4. Qualifying circumstances

Individuals eligible to receive CPT code 90674 services include those who are at least four years old and require protection against the influenza virus. The vaccine is particularly recommended for individuals at higher risk of complications from the flu, such as the elderly, pregnant women, and those with chronic medical conditions. However, it is important to note that the vaccine may not be suitable for individuals with certain allergies or sensitivities, and the healthcare provider should carefully assess each patient’s medical history before administering the vaccine.

5. When to use CPT code 90674

It is appropriate to bill the 90674 CPT code when the healthcare provider supplies and administers the quadrivalent cell culture-derived influenza virus vaccine to a patient who meets the eligibility criteria. This code should be used specifically for the supply of the vaccine and not for the administration or office visit. Separate codes should be reported for vaccine administration and any associated office visits.

6. Documentation requirements

To support a claim for CPT 90674, the healthcare provider must document the following information:

• Patient’s age, medical history, and any relevant allergies or sensitivities
• Discussion of immunization options, risks, benefits, and potential side effects
• Selection of the appropriate vaccine based on the patient’s needs
• Preparation and administration of the 0.5 mL dosage of the quadrivalent cell culture-derived influenza virus vaccine
• Product used, administration route, and purpose of the vaccine

7. Billing guidelines

When billing for CPT code 90674, it is important to follow the appropriate guidelines and rules to ensure accurate reimbursement. These guidelines include:

• Reporting separate codes for the vaccine supply (CPT 90674), vaccine administration, and any associated office visits
• Providing sufficient documentation to support the claim, as outlined in the documentation requirements section
• Reviewing payer-specific guidelines and policies, as some payers may have additional requirements or restrictions related to the use of CPT 90674

8. Historical information

CPT 90674 was added to the Current Procedural Terminology system on January 1, 2017. There have been no updates to the code since its addition.

9. Similar codes to CPT 90674

There are several other codes related to influenza virus vaccines that differentiate from CPT 90674 in various ways, including:

• CPT 90672: A live attenuated influenza vaccine for intranasal use
• CPT 90673: A trivalent cell culture-derived influenza virus vaccine for intramuscular use
• CPT 90686: A quadrivalent influenza virus vaccine without adjuvant for intramuscular use
• CPT 90687: A quadrivalent influenza virus vaccine with adjuvant for intramuscular use
• CPT 90688: A quadrivalent influenza virus vaccine for intradermal use

10. Examples

1. A 45-year-old patient with a history of asthma receives the quadrivalent cell culture-derived influenza virus vaccine to protect against the flu.
2. A 65-year-old patient with diabetes receives the vaccine to reduce the risk of flu-related complications.
3. A 30-year-old pregnant woman receives the vaccine to protect both herself and her unborn child from the flu.
4. A 5-year-old child receives the vaccine as part of their routine immunization schedule.
5. A healthcare worker receives the vaccine to reduce the risk of transmitting the flu to vulnerable patients.
6. A 50-year-old patient with a history of heart disease receives the vaccine to lower the risk of flu-related complications.
7. A 28-year-old patient with no known risk factors receives the vaccine as a preventive measure during flu season.
8. A 75-year-old patient living in a long-term care facility receives the vaccine to protect against potential flu outbreaks.
9. A 40-year-old patient with a compromised immune system due to cancer treatment receives the vaccine to reduce the risk of flu-related complications.
10. A 55-year-old patient with chronic obstructive pulmonary disease (COPD) receives the vaccine to lower the risk of flu-related respiratory issues.