How To Use CPT Code 90715

CPT 90715 describes the administration of the tetanus, diphtheria toxoids and acellular pertussis vaccine (Tdap) to individuals who are 7 years old or older. 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 90715?

CPT 90715 is used to report the administration of the Tdap vaccine to individuals who are 7 years old or older. This vaccine is a combination vaccine that helps protect against tetanus, diphtheria, and pertussis (whooping cough). It is typically given as a booster to individuals who have previously received the DTaP vaccine.

2. Official Description

The official description of CPT code 90715 is: ‘Tetanus, diphtheria toxoids and acellular pertussis vaccine (Tdap), when administered to individuals 7 years or older, 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, and potential side effects of the Tdap vaccine are reviewed with the patient or their parent/guardian.
3. The vaccine is administered intramuscularly, typically into the arm or thigh muscle.
4. A single dose of the Tdap vaccine is given to children aged 7 to 10 years who did not receive all five doses of the DTaP vaccine.
5. Children aged 11 and 12 years receive a single booster dose if they received all five doses of the DTaP vaccine when they were younger.
6. Adults, especially those aged 65 or older who have never received the Tdap vaccine, receive one shot of Tdap.
7. Pregnant women receive a single dose of Tdap during each pregnancy.

4. Qualifying circumstances

CPT 90715 is used for the administration of the Tdap vaccine to individuals who are 7 years old or older. It is important to note that this code is specific to the Tdap vaccine and should not be used for other vaccines or immunizations.

5. When to use CPT code 90715

CPT code 90715 should be used when administering the Tdap vaccine to individuals who are 7 years old or older. It is important to ensure that the patient meets the age requirement and that the vaccine being administered is specifically the Tdap vaccine.

6. Documentation requirements

To support a claim for CPT 90715, the healthcare provider must document the following information:

• The administration of the Tdap vaccine
• The date of administration
• The route of administration (intramuscular)
• The purpose of the vaccine (protection against tetanus, diphtheria, and pertussis)
• The patient’s age (7 years or older)
• Any relevant medical history or contraindications
• Signature of the healthcare provider administering the vaccine

7. Billing guidelines

When billing for CPT 90715, ensure that the vaccine being administered is the Tdap vaccine and that the patient meets the age requirement of 7 years or older. It is important to follow the specific guidelines of each insurance company regarding reporting vaccines and any associated evaluation and management (E/M) codes. Modifier 25 may be required for certain insurance companies when reporting an office visit along with the vaccine administration.

8. Historical information

CPT 90715 was added to the Current Procedural Terminology system on January 1, 2004. There have been no updates or changes to the code since its addition.

9. Examples

1. A healthcare provider administers the Tdap vaccine to a 10-year-old child who did not receive all five doses of the DTaP vaccine.
2. An adult aged 30 receives a single dose of the Tdap vaccine as a booster.
3. A pregnant woman receives a dose of Tdap during her third trimester.
4. A healthcare provider administers the Tdap vaccine to a 12-year-old child who received all five doses of the DTaP vaccine when younger.
5. An elderly individual aged 70 receives a single dose of the Tdap vaccine.
6. A healthcare provider administers the Tdap vaccine to a 9-year-old child who did not receive any doses of the DTaP vaccine.
7. A pregnant woman receives a dose of Tdap during her second trimester.
8. An adult aged 40 receives a single dose of the Tdap vaccine as a booster.
9. A healthcare provider administers the Tdap vaccine to a 13-year-old child who received all five doses of the DTaP vaccine when younger.
10. An elderly individual aged 75 receives a single dose of the Tdap vaccine.