How To Use CPT Code 90702

CPT 90702 describes the administration of a combination vaccine for diphtheria and tetanus toxoids to individuals younger than seven years. 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 90702?

CPT 90702 can be used to describe the administration of a combination vaccine for diphtheria and tetanus toxoids to individuals younger than seven years. This code is used when a healthcare provider administers the vaccine intramuscularly to protect against these diseases.

2. Official Description

The official description of CPT code 90702 is: ‘Diphtheria and tetanus toxoids adsorbed (DT) when administered to individuals younger than 7 years, for intramuscular use.’

3. Procedure

1. The healthcare provider presents the parent, guardian, or patient with the options for immunization.
2. He reviews the risks and benefits of the vaccine, along with the potential side effects.
3. Once the patient is appropriately prepped, the provider administers the vaccine intramuscularly in the deltoid muscle of the upper arm or anterolateral aspect of the thigh.

4. Qualifying circumstances

Individuals eligible to receive CPT 90702 are those younger than seven years who require immunization against diphtheria and tetanus. The vaccine is typically administered as part of a series, with infants between six weeks and two months of age starting the DT vaccine series, which should be completed by their seventh birthday. Older children and adults may need a booster injection if injured and they have not had a tetanus vaccine injection in the last five to 10 years.

5. When to use CPT code 90702

CPT code 90702 should be used when a healthcare provider administers the diphtheria and tetanus toxoids vaccine to individuals younger than seven years. It is important to ensure that the vaccine is administered intramuscularly and that the patient falls within the appropriate age range.

6. Documentation requirements

To support a claim for CPT 90702, the healthcare provider must document the following information:

• Product administered
• Administration route
• Purpose of the vaccine

7. Billing guidelines

When billing for CPT 90702, ensure that the vaccine is administered to individuals younger than seven years and that it is administered intramuscularly. It is important to follow the specific guidelines of Medicare and private insurance companies regarding reporting vaccines and any associated evaluation and management (E/M) codes. Modifier 25 may need to be appended to the E/M code in some cases.

8. Historical information

CPT 90702 was added to the Current Procedural Terminology system on January 1, 1990. There have been several code changes since its addition, with the most recent change occurring on January 1, 2016.

9. Examples

1. A healthcare provider administers the diphtheria and tetanus toxoids vaccine to a six-year-old child.
2. A nurse administers the combination vaccine to a four-year-old patient to protect against diphtheria and tetanus.
3. A pediatrician administers the vaccine to a two-month-old infant as part of the DT vaccine series.
4. A healthcare provider administers the vaccine to a seven-year-old child who requires a booster injection due to an injury.
5. A nurse administers the vaccine to an adult who has not had a tetanus vaccine injection in the last 10 years.