How To Use CPT Code 90691

CPT 90691 describes the administration of the Vi capsular polysaccharide vaccine intramuscularly to prevent typhoid fever. 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 90691?

CPT 90691 can be used to describe the administration of the Vi capsular polysaccharide vaccine intramuscularly to protect against typhoid fever. This code is used when a healthcare provider injects the vaccine into the deltoid muscle of the upper outer arm for adults or either the deltoid or the muscle on the outside of the upper leg for children.

2. Official Description

The official description of CPT code 90691 is: ‘Typhoid vaccine, Vi capsular polysaccharide (ViCPs), for intramuscular use.’

3. Procedure

1. The healthcare provider presents the options for immunization to the parent, guardian, or patient.
2. The risks, benefits, and potential side effects of the vaccine are reviewed with the patient.
3. The patient is appropriately prepped, and the vaccine is injected into the deltoid muscle for adults or the deltoid or muscle on the outside of the upper leg for children.
4. The provider completes the immunization at least two weeks prior to potential exposure to Salmonella typhi, the organism that causes typhoid fever.

4. Qualifying circumstances

Patients eligible to receive CPT 90691 are those who require protection against typhoid fever. The vaccine is administered by a healthcare provider, and the patient must be appropriately prepped for the injection. The vaccine is given intramuscularly, either in the deltoid muscle of the upper outer arm for adults or in the deltoid or muscle on the outside of the upper leg for children.

5. When to use CPT code 90691

CPT code 90691 should be used when a healthcare provider administers the Vi capsular polysaccharide vaccine intramuscularly to protect against typhoid fever. It is important to ensure that the vaccine is given at least two weeks prior to potential exposure to Salmonella typhi. This code should not be used for other types of vaccines or routes of administration.

6. Documentation requirements

To support a claim for CPT 90691, the healthcare provider must document the following information:

• The administration of the Vi capsular polysaccharide vaccine
• The route of administration (intramuscular)
• The specific muscle where the vaccine was injected (deltoid for adults or deltoid/upper leg for children)
• The date of administration
• Any relevant patient information, such as allergies or previous adverse reactions
• Signature of the healthcare provider administering the vaccine

7. Billing guidelines

When billing for CPT 90691, ensure that the vaccine is administered intramuscularly by a healthcare provider. Use the appropriate diagnosis code to indicate the need for typhoid fever protection. It is important to follow the specific guidelines of each insurance company regarding reporting vaccines and associated evaluation and management (E/M) codes. Modifier 25 may be required for certain payers. Check with individual payers for their specific guidelines and policies.

8. Historical information

CPT 90691 was added to the Current Procedural Terminology system on January 1, 1999. There have been no updates to the code since its addition.

9. Examples

1. A healthcare provider administers the Vi capsular polysaccharide vaccine intramuscularly to a patient traveling to a region with a high risk of typhoid fever.
2. A nurse injects the vaccine into the deltoid muscle of an adult patient who will be working in a typhoid-endemic area.
3. A pediatrician administers the vaccine to a child, injecting it into the muscle on the outside of the upper leg.
4. A healthcare provider immunizes a patient who will be participating in a medical mission trip to a typhoid-prone region.
5. A travel clinic nurse gives the vaccine to a patient who will be visiting a country with a high incidence of typhoid fever.
6. A healthcare provider administers the Vi capsular polysaccharide vaccine intramuscularly to a patient who will be working in a refugee camp with limited access to clean water.
7. A nurse injects the vaccine into the deltoid muscle of a patient who will be volunteering in a typhoid-affected area.
8. A pediatrician immunizes a child, injecting the vaccine into the deltoid muscle of the upper outer arm.
9. A healthcare provider administers the vaccine to a patient who will be traveling to a region with a recent typhoid outbreak.
10. A travel clinic nurse gives the vaccine to a patient who will be attending a music festival in a typhoid-prone area.