CPT 90715 | Tdap Vaccine (Tetanus, Diphtheria & Acellular Pertussis)
CPT code 90715 can be used to report the Tdap vaccine. This combination vaccine protects against tetanus, diphtheria, and pertussis for individuals seven years or older and is administered intramuscularly.
What Is CPT Code 90715?
CPT 90715 describes the administration of a specific vaccine called the Tdap vaccine.
The Tdap vaccine is a combination vaccine that includes protection against three different illnesses: tetanus, diphtheria, and pertussis (also known as whooping cough). The vaccine is designed for use in individuals seven years or older.
The vaccine has to be administered intramuscularly (directly into the muscle) rather than under the skin or in a different location. This route of administration is chosen because it leads to a more potent and effective immune response.
Description
The CPT book describes CPT code 90715 as: “Tetanus, diphtheria toxoids and acellular pertussis vaccine (Tdap), when administered to individuals seven years or older, for intramuscular use.”
Procedure
The healthcare provider often employs a combination vaccine, specifically the Tdap vaccine, as a booster for seven or older patients.
The Tdap vaccine protects lockjaw, diphtheria, and whooping cough.
The provider presents the parent or guardian, or the patient if they are of age, with the options for immunization and will thoroughly review the risks, benefits, and potential side effects associated with the vaccine.
Once the patient or their guardian consented to receive the vaccine, the healthcare provider will administer it intramuscularly, directly into the arm or thigh muscle.
This three-in-one vaccine is typically given to children between the ages of 7 and 10 years old who have not received all five DTaP vaccines.
Children between 11 and 12 years of age will receive a single booster dose if they have previously received all five DTaP shots.
Adults, particularly those 65 years or older who have never had Tdap, will receive one vaccine shot.
Pregnant women will receive a single dose of the Tdap vaccine during each pregnancy.
The Tdap vaccine protects individuals against lockjaw, diphtheria, and whooping cough.
The healthcare provider will work closely with patients and their guardians to ensure they are fully informed and comfortable with the process before administering the vaccine.
How To Use CPT 90715
You can use CPT code 90715 only for the Tdap vaccine and not the administration of it because separate codes are required to be reported for the vaccine administration, the vaccine itself, and the office visit based on the documentation provided.
To ensure that CPT 90715 is properly applied, you need to provide sufficient documentation from your healthcare provider that explains the product that was administered, the method of administration, and the purpose of the vaccination.
You can check with the insurance company for their specific guidelines on reporting vaccines, as some insurance companies may require modifier 25 to be added to the evaluation and management (E/M) code.
Additionally, guidelines may vary between Medicare and private insurance companies, so you should check with each payer for their specific requirements. It’s always recommended to have the policy in writing. This will protect your practice if the payer questions your modifier use, which is inconsistent with CPT guidelines.
