How To Use CPT Code 90653

CPT 90653 describes the administration of an influenza vaccine, specifically an inactivated (IIV), subunit, adjuvanted vaccine, for intramuscular use. This article will cover the description, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information, similar codes and billing examples.

1. What is CPT Code 90653?

CPT 90653 is used to report the administration of an influenza vaccine. This particular code is specifically for an inactivated (IIV), subunit, adjuvanted vaccine, which is given through an intramuscular injection. The vaccine is designed to provide immunity against influenza, a severe and infectious respiratory disease.

2. Official Description

The official description of CPT code 90653 is: ‘Influenza vaccine, inactivated (IIV), subunit, adjuvanted, for intramuscular use.’

3. Procedure

1. The healthcare provider prepares the patient for the administration of the influenza vaccine.
2. The provider administers the inactivated, subunit, adjuvanted influenza vaccine into the muscle of the upper arm.
3. Before administering the vaccine, the provider counsels the patient, providing instructions and precautions.

4. Qualifying circumstances

CPT 90653 is used when a patient receives an inactivated (IIV), subunit, adjuvanted influenza vaccine through an intramuscular injection. This vaccine is typically given to protect against infection with the influenza virus. The administration of the vaccine must be performed by a qualified healthcare provider.

5. When to use CPT code 90653

CPT code 90653 should be used when a healthcare provider administers an inactivated (IIV), subunit, adjuvanted influenza vaccine through an intramuscular injection. It is important to note that this code should not be used for other types of influenza vaccines or routes of administration.

6. Documentation requirements

To support a claim for CPT 90653, the healthcare provider must document the following information:

• The specific influenza vaccine administered (inactivated, subunit, adjuvanted)
• The route of administration (intramuscular)
• Date of administration
• Any counseling provided to the patient

7. Billing guidelines

When billing for CPT 90653, ensure that the healthcare provider administered the inactivated (IIV), subunit, adjuvanted influenza vaccine through an intramuscular injection. It is important to follow the specific guidelines and requirements set by the payer for proper reimbursement. Additionally, it is crucial to document the administration of the vaccine and any counseling provided to the patient.

8. Historical information

CPT 90653 was added to the Current Procedural Terminology system on January 1, 2013. There have been no updates or changes to the code since its addition.

9. Examples

1. A healthcare provider administers an inactivated, subunit, adjuvanted influenza vaccine to a patient to protect against influenza.
2. A nurse gives an intramuscular injection of an inactivated, subunit, adjuvanted influenza vaccine to a patient during a flu vaccination clinic.
3. A physician administers an inactivated, subunit, adjuvanted influenza vaccine to a patient with a high risk of complications from influenza.
4. A pharmacist provides an intramuscular injection of an inactivated, subunit, adjuvanted influenza vaccine to a patient at a community health fair.
5. A healthcare provider counsels a patient on the benefits and potential side effects of an inactivated, subunit, adjuvanted influenza vaccine before administering it through an intramuscular injection.
6. A nurse administers an inactivated, subunit, adjuvanted influenza vaccine to a patient as part of a routine immunization schedule.
7. A healthcare provider gives an intramuscular injection of an inactivated, subunit, adjuvanted influenza vaccine to a patient who will be traveling to an area with a high risk of influenza.
8. A pharmacist provides an inactivated, subunit, adjuvanted influenza vaccine to a patient who is pregnant and wants to protect herself and her baby from influenza.
9. A healthcare provider administers an intramuscular injection of an inactivated, subunit, adjuvanted influenza vaccine to a patient with a weakened immune system.
10. A nurse gives an inactivated, subunit, adjuvanted influenza vaccine to a patient who is elderly and at a higher risk of complications from influenza.