How To Use CPT Code 90714

CPT 90714 refers to the administration of a preservative-free combination vaccine for diphtheria and tetanus toxoids for individuals aged 7 years or older. This article will cover the description, procedure, qualifying circumstances, usage, documentation requirements, billing guidelines, historical information, similar codes, and examples of CPT 90714.

1. What is CPT 90714?

CPT 90714 is a medical billing code used to describe the administration of a preservative-free combination vaccine for diphtheria and tetanus toxoids. This vaccine is administered intramuscularly to individuals aged 7 years or older to prevent these diseases. Medical coders and billers use this code to accurately document and bill for this specific immunization service.

2. 90714 CPT code description

The official description of CPT code 90714 is: “Tetanus and diphtheria toxoids adsorbed (Td), preservative free, when administered to individuals 7 years or older, for intramuscular use.”

3. Procedure

The 90714 procedure involves the following steps:

1. The provider presents the parent, guardian, or patient with the options for immunization and reviews the risks, benefits, and potential side effects.
2. The patient is appropriately prepped for the vaccine administration.
3. The provider administers the preservative-free combination vaccine for diphtheria and tetanus toxoids intramuscularly in the deltoid muscle of the upper arm or anterolateral aspect of the thigh.
4. Post-vaccination, the provider monitors the patient for any immediate adverse reactions and provides necessary care if needed.

4. Qualifying circumstances

Individuals eligible to receive CPT code 90714 services are those aged 7 years or older who require immunization against diphtheria and tetanus. This may include individuals who have never been vaccinated, those who require booster shots, or those with specific medical conditions that warrant the administration of the vaccine. The provider should assess the patient’s medical history, previous immunizations, and current health status to determine eligibility for the vaccine.

5. When to use CPT code 90714

It is appropriate to bill the 90714 CPT code when a healthcare provider administers the preservative-free combination vaccine for diphtheria and tetanus toxoids to an individual aged 7 years or older. This code should be used for each administration of the vaccine, regardless of whether it is an initial dose or a booster shot.

6. Documentation requirements

To support a claim for CPT 90714, the following information should be documented:

• Patient’s age and medical history, including previous immunizations
• Indication for the vaccine administration (e.g., initial dose, booster shot, or specific medical condition)
• Details of the vaccine administered, including the manufacturer, lot number, and expiration date
• Route of administration (intramuscular)
• Site of injection (deltoid muscle of the upper arm or anterolateral aspect of the thigh)
• Date of administration
• Provider’s signature or electronic authentication

7. Billing guidelines

When billing for CPT code 90714, it is essential to follow the specific guidelines and rules set by individual payers. Some insurance companies may require the use of modifier 25 to be appended to the associated evaluation and management (E/M) code. Medicare and private insurance companies might have different guidelines for reporting any vaccines or for reporting certain vaccines during the same visit, such as flu and pneumonia vaccines. It is crucial to check with individual payers for their specific guidelines and have the policy in writing to protect your practice in the event of any discrepancies.

8. Historical information

CPT 90714 was added to the Current Procedural Terminology system on January 1, 2006. Since then, there have been several updates to the code description, with the most recent change occurring on January 1, 2016.

9. Similar codes to CPT 90714

Five similar codes to CPT 90714 and how they differ are:

• CPT 90715: This code is used for the administration of a tetanus, diphtheria, and acellular pertussis vaccine (Tdap) for individuals aged 7 years or older.
• CPT 90716: This code refers to the administration of a varicella (chickenpox) vaccine.
• CPT 90718: This code is used for the administration of a tetanus toxoid vaccine, which only protects against tetanus.
• CPT 90700: This code is for the administration of a diphtheria, tetanus toxoids, and acellular pertussis vaccine (DTaP) for individuals younger than 7 years.
• CPT 90723: This code is used for the administration of a combination vaccine that includes protection against diphtheria, tetanus, pertussis, hepatitis B, and poliovirus.

10. Examples

Here are 10 detailed examples of CPT code 90714 procedures:

1. A 7-year-old child receiving their first dose of the Td vaccine as part of their routine immunization schedule.
2. A 12-year-old patient receiving a Td booster shot during a routine check-up.
3. An adult with a history of incomplete immunization receiving the Td vaccine to ensure protection against diphtheria and tetanus.
4. A healthcare worker receiving a Td booster shot as part of their occupational health requirements.
5. An individual traveling to a region with a high prevalence of diphtheria receiving the Td vaccine for protection.
6. A patient with a chronic medical condition requiring the Td vaccine for additional protection against diphtheria and tetanus.
7. An individual receiving a Td booster shot following a tetanus-prone injury, such as a deep puncture wound.
8. A pregnant woman receiving the Td vaccine during the third trimester to protect both herself and her unborn child from diphtheria and tetanus.
9. An elderly patient receiving the Td vaccine as part of their routine adult immunization schedule.
10. A patient with a history of an adverse reaction to a pertussis-containing vaccine receiving the Td vaccine as an alternative.