How To Use CPT Code 90473
CPT 90473 describes the administration of an attenuated vaccine through the intranasal or oral route. This article will cover the official description, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information, similar codes and billing examples.
1. What is CPT Code 90473?
CPT 90473 can be used to describe the administration of an attenuated vaccine through the intranasal or oral route. This code is used when a healthcare provider immunizes a patient using a single vaccine via the nose or mouth.
2. Official Description
The official description of CPT code 90473 is: ‘Immunization administration by intranasal or oral route; 1 vaccine (single or combination vaccine/toxoid).’ It is important to note that CPT 90473 should not be reported in conjunction with CPT 90471.
3. Procedure
- The healthcare provider prepares the patient for immunization through the intranasal or oral route.
- Using a single vaccine, the provider administers the immunization via the nose or mouth.
4. Qualifying circumstances
CPT 90473 is used when a healthcare provider administers an attenuated vaccine through the intranasal or oral route. Attenuated vaccines are made from live microorganisms that are cultured under specific conditions to retain their ability to provide immunity. This code is used for immunization procedures and should not be used for other types of treatments or services.
5. When to use CPT code 90473
CPT code 90473 should be used when a healthcare provider administers a single vaccine through the intranasal or oral route. It is important to note that this code should not be reported in conjunction with CPT code 90471.
6. Documentation requirements
To support a claim for CPT 90473, the healthcare provider must document the following information:
- Patient’s diagnosis and the need for immunization
- Specific vaccine administered
- Date and route of administration (intranasal or oral)
7. Billing guidelines
When billing for CPT 90473, ensure that the healthcare provider administers a single vaccine through the intranasal or oral route. If multiple vaccines are administered, use CPT code 90474 for each additional vaccine. It is important to follow the guidelines provided by the payer and ensure accurate coding and documentation.
8. Historical information
CPT 90473 was added to the Current Procedural Terminology system on January 1, 2002. The code was later updated on January 1, 2010, with a revised description: ‘Immunization administration by intranasal or oral route; one vaccine (single or combination vaccine/toxoid).’ No further updates have been made to the code since then.
9. Examples
- A healthcare provider administers a live attenuated influenza vaccine through the intranasal route to a patient.
- A nurse immunizes a child with a rotavirus vaccine through the oral route.
- A physician administers a measles, mumps, and rubella (MMR) combination vaccine through the intranasal route to a patient.
- A healthcare provider administers a varicella (chickenpox) vaccine through the oral route to a patient.
- A nurse immunizes an adult with a polio vaccine through the intranasal route.
- A physician administers a typhoid vaccine through the oral route to a patient.
- A healthcare provider administers a live attenuated influenza vaccine through the intranasal route to a patient.
- A nurse immunizes a child with a rotavirus vaccine through the oral route.
- A physician administers a measles, mumps, and rubella (MMR) combination vaccine through the intranasal route to a patient.
- A healthcare provider administers a varicella (chickenpox) vaccine through the oral route to a patient.
