How To Use CPT Code 90723

CPT 90723 describes the administration of a combination inactivated vaccine intramuscularly to prevent multiple diseases, including diphtheria, tetanus, acellular pertussis, hepatitis B, and polio. 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 90723?

CPT 90723 can be used to describe the administration of a combination inactivated vaccine intramuscularly to protect against multiple diseases, such as diphtheria, tetanus, acellular pertussis, hepatitis B, and polio. This code is used when a healthcare provider administers the vaccine to a patient to prevent these diseases.

2. Official Description

The official description of CPT code 90723 is: ‘Diphtheria, tetanus toxoids, acellular pertussis vaccine, hepatitis B, and inactivated poliovirus vaccine (DTaP-HepB-IPV), 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. When the patient is appropriately prepped, the provider administers the vaccine intramuscularly in the muscle of the upper arm or leg.

4. Qualifying circumstances

Patients eligible to receive CPT 90723 are those who require protection against multiple diseases, including diphtheria, tetanus, acellular pertussis, hepatitis B, and polio. The vaccine is administered by a healthcare provider intramuscularly.

5. When to use CPT code 90723

CPT code 90723 should be used when a healthcare provider administers the combination inactivated vaccine intramuscularly to protect against diphtheria, tetanus, acellular pertussis, hepatitis B, and polio. It is important to use this code when reporting the administration of this specific vaccine.

6. Documentation requirements

To support a claim for CPT 90723, the healthcare provider must document the following information:

• The specific vaccine administered (DTaP-HepB-IPV)
• The route of administration (intramuscular)
• The date of administration
• The location of administration (upper arm or leg)
• 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 90723, ensure that the healthcare provider administers the combination inactivated vaccine intramuscularly. Follow the specific guidelines provided by Medicare and private insurance companies for reporting this vaccine. It is important to include sufficient documentation to support the administration of the vaccine, including the product administered, administration route, and purpose.

8. Historical information

CPT 90723 was added to the Current Procedural Terminology system on January 1, 2001. There was a code change on January 1, 2015, which updated the description of the vaccine.

9. Examples

1. A healthcare provider administers the DTaP-HepB-IPV vaccine to a 2-year-old child to protect against diphtheria, tetanus, acellular pertussis, hepatitis B, and polio.
2. A nurse administers the DTaP-HepB-IPV vaccine to a pregnant woman to provide immunity to her unborn child against diphtheria, tetanus, acellular pertussis, hepatitis B, and polio.
3. A healthcare provider administers the DTaP-HepB-IPV vaccine to a 65-year-old individual to boost their immunity against diphtheria, tetanus, acellular pertussis, hepatitis B, and polio.
4. A nurse administers the DTaP-HepB-IPV vaccine to a patient traveling to a region with a high risk of diphtheria, tetanus, acellular pertussis, hepatitis B, and polio.
5. A healthcare provider administers the DTaP-HepB-IPV vaccine to a patient with a compromised immune system to protect against diphtheria, tetanus, acellular pertussis, hepatitis B, and polio.
6. A nurse administers the DTaP-HepB-IPV vaccine to a healthcare worker to ensure their protection against diphtheria, tetanus, acellular pertussis, hepatitis B, and polio.
7. A healthcare provider administers the DTaP-HepB-IPV vaccine to a patient who missed their childhood immunizations to provide protection against diphtheria, tetanus, acellular pertussis, hepatitis B, and polio.
8. A nurse administers the DTaP-HepB-IPV vaccine to a patient with a history of adverse reactions to other vaccines to monitor their response and provide protection against diphtheria, tetanus, acellular pertussis, hepatitis B, and polio.
9. A healthcare provider administers the DTaP-HepB-IPV vaccine to a patient preparing for international travel to protect against diphtheria, tetanus, acellular pertussis, hepatitis B, and polio.