How To Use CPT Code 90689

CPT 90689 describes the administration of a quadrivalent influenza virus vaccine, which provides immunity against four different strains of the influenza virus. 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 90689?

CPT 90689 is used to describe the administration of a quadrivalent influenza virus vaccine. This vaccine is designed to provide immunity against four different strains of the influenza virus. It is administered by injecting 0.25 mL of the vaccine into the patient’s muscle, typically in the deltoid muscle of the upper arm or the anterolateral aspect of the thigh.

2. Official Description

The official description of CPT code 90689 is: ‘Influenza virus vaccine, quadrivalent (IIV4), inactivated, adjuvanted, 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 parent/guardian.
2. The risks, benefits, potential side effects, and instructions/precautions are reviewed with the patient or their parent/guardian.
3. The patient is appropriately prepped, and informed consent is obtained.
4. The healthcare provider administers 0.25 mL of the quadrivalent influenza virus vaccine into the patient’s muscle.
5. The vaccine is typically injected into the deltoid muscle of the upper arm or the anterolateral aspect of the thigh.

4. Qualifying circumstances

CPT 90689 is used for patients who require immunization against four different strains of the influenza virus. The vaccine is administered by a healthcare provider and is suitable for patients of all ages. It is important to note that the vaccine is preservative-free and derived from cell cultures of a killed virus. The vaccine also contains an adjuvant, which is a substance that boosts the patient’s immune response to the vaccine.

5. When to use CPT code 90689

CPT code 90689 should be used when a healthcare provider administers the quadrivalent influenza virus vaccine to a patient. It is important to ensure that the vaccine is administered in the correct dosage (0.25 mL) and via the intramuscular route. This code should be used for each individual patient who receives the vaccine.

6. Documentation requirements

To support a claim for CPT 90689, the healthcare provider must document the following information:

• Administration of the quadrivalent influenza virus vaccine
• Date of administration
• Route of administration (intramuscular)
• Dosage administered (0.25 mL)
• Location of injection (deltoid muscle or anterolateral aspect of the thigh)
• Signature of the healthcare provider administering the vaccine

7. Billing guidelines

When billing for CPT 90689, ensure that the vaccine is administered by a qualified healthcare provider and that the dosage and route of administration are correct. It is important to follow the specific guidelines provided by the payer to ensure accurate billing. Additionally, consider reporting separate codes for vaccine administration, the actual vaccine, and any associated office visits, if applicable.

8. Historical information

CPT 90689 was added to the Current Procedural Terminology system on January 1, 2019. There have been no updates or changes to the code since its addition.

9. Examples

1. A healthcare provider administers the quadrivalent influenza virus vaccine to a 65-year-old patient to protect against four different strains of the influenza virus.
2. A nurse administers the quadrivalent influenza virus vaccine to a 5-year-old child to provide immunity against four different strains of the influenza virus.
3. A physician administers the quadrivalent influenza virus vaccine to a pregnant woman to protect her and her unborn child against four different strains of the influenza virus.
4. A pharmacist administers the quadrivalent influenza virus vaccine to a group of elderly residents in a nursing home to prevent the spread of influenza among the residents.
5. A healthcare provider administers the quadrivalent influenza virus vaccine to a patient with a compromised immune system to provide additional protection against four different strains of the influenza virus.