How To Use CPT Code 90655

CPT 90655 describes the administration of a preservative-free influenza virus vaccine, trivalent (IIV3), in a 0.25 mL dosage, 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 90655?

CPT 90655 is used to report the administration of a preservative-free influenza virus vaccine, trivalent (IIV3), in a 0.25 mL dosage, for intramuscular use. This vaccine is designed to provide immunity against three forms of influenza, a severe and infectious respiratory disease.

2. Official Description

The official description of CPT code 90655 is: ‘Influenza virus vaccine, trivalent (IIV3), split virus, preservative free, 0.25 mL dosage, for intramuscular use.’

3. Procedure

1. The healthcare provider presents the options for immunization to the patient or their guardian, explaining the risks, benefits, potential side effects, and providing instructions and precautions.
2. The provider administers a 0.25 mL dosage of the preservative-free influenza virus vaccine, trivalent (IIV3), into the patient’s muscle.
3. The vaccine is designed to protect the patient against three different strains of the influenza virus.

4. Qualifying circumstances

CPT 90655 is used when a patient receives the preservative-free influenza virus vaccine, trivalent (IIV3), in a 0.25 mL dosage, for intramuscular use. This vaccine is typically administered to individuals who are at risk of contracting influenza or its complications. It is important to note that CPT 90655 is specifically for the preservative-free version of the vaccine.

5. When to use CPT code 90655

CPT code 90655 should be used when a healthcare provider administers the preservative-free influenza virus vaccine, trivalent (IIV3), in a 0.25 mL dosage, for intramuscular use. It is important to ensure that the vaccine administered matches the specific code description to accurately report the service.

6. Documentation requirements

To support a claim for CPT 90655, the healthcare provider must document the following information:

• The administration of the preservative-free influenza virus vaccine, trivalent (IIV3), in a 0.25 mL dosage
• The route of administration (intramuscular)
• Date of administration
• Signature of the healthcare provider administering the vaccine

7. Billing guidelines

When billing for CPT 90655, ensure that the vaccine administered matches the specific code description. It is important to follow the guidelines provided by the payer and accurately report the service. Additionally, consider reporting separate codes for vaccine administration, the actual vaccine, and any associated office visit, if applicable.

8. Historical information

CPT 90655 was added to the Current Procedural Terminology system on January 1, 2004. There have been several historical changes to the code, including updates to the description and age specifications for administration.

9. Examples

1. A healthcare provider administers the preservative-free influenza virus vaccine, trivalent (IIV3), in a 0.25 mL dosage, to a patient to protect against influenza.
2. A nurse administers the preservative-free influenza virus vaccine, trivalent (IIV3), in a 0.25 mL dosage, to a child to provide immunity against three forms of influenza.
3. A physician administers the preservative-free influenza virus vaccine, trivalent (IIV3), in a 0.25 mL dosage, to an elderly patient to protect against influenza and its complications.
4. A healthcare provider administers the preservative-free influenza virus vaccine, trivalent (IIV3), in a 0.25 mL dosage, to a pregnant woman to provide immunity against influenza during pregnancy.
5. A nurse administers the preservative-free influenza virus vaccine, trivalent (IIV3), in a 0.25 mL dosage, to a patient with a compromised immune system to protect against influenza.
6. A healthcare provider administers the preservative-free influenza virus vaccine, trivalent (IIV3), in a 0.25 mL dosage, to a patient with a chronic respiratory condition to prevent influenza-related complications.
7. A nurse administers the preservative-free influenza virus vaccine, trivalent (IIV3), in a 0.25 mL dosage, to a healthcare worker to protect against influenza and reduce the risk of transmission to patients.
8. A physician administers the preservative-free influenza virus vaccine, trivalent (IIV3), in a 0.25 mL dosage, to a patient with a heart condition to prevent influenza-related exacerbations.
9. A healthcare provider administers the preservative-free influenza virus vaccine, trivalent (IIV3), in a 0.25 mL dosage, to a child with asthma to protect against influenza and reduce the risk of respiratory complications.
10. A nurse administers the preservative-free influenza virus vaccine, trivalent (IIV3), in a 0.25 mL dosage, to a patient with diabetes to prevent influenza-related complications.