© Copyright 2025 American Medical Association. All rights reserved.
The CPT® Code 90380 refers to a specific monoclonal antibody vaccine designed to provide protection against respiratory syncytial virus (RSV). This vaccine is administered in a seasonal dose of 0.5 mL via intramuscular injection. The primary function of this vaccine is to stimulate the recipient's immune system to produce antibodies that can effectively combat RSV, a virus known for causing acute respiratory infections, particularly in vulnerable populations such as infants, young children, and individuals with compromised immune systems or pre-existing respiratory conditions. RSV is notably seasonal, with higher circulation rates during the fall and winter months, making timely vaccination crucial for at-risk groups. The monoclonal antibody contained in this vaccine is engineered to mimic the natural immune response, thereby enhancing the body’s ability to recognize and fight off the virus upon subsequent exposures. It is particularly important for infants and neonates entering their first RSV season, as they are at a heightened risk for severe illness, including pneumonia and hospitalization. The administration of this vaccine is a preventive measure aimed at reducing the incidence of RSV-related complications in these high-risk populations.
© Copyright 2025 Coding Ahead. All rights reserved.
The monoclonal antibody vaccine represented by CPT® Code 90380 is indicated for specific populations at high risk for severe respiratory syncytial virus (RSV) infection. The following conditions and circumstances warrant the administration of this vaccine:
The administration of the monoclonal antibody vaccine involves several key procedural steps to ensure safety and efficacy:
Following the administration of the monoclonal antibody vaccine, patients are generally advised to observe for any side effects, which may include mild reactions such as soreness at the injection site, low-grade fever, or irritability. It is important for caregivers to be informed about these potential reactions and to seek medical attention if any severe or unusual symptoms occur. The vaccine is intended to provide protection throughout the RSV season, and patients should be counseled on the importance of follow-up care and monitoring for respiratory symptoms during this time. Additionally, the vaccine does not provide immediate immunity; therefore, it is crucial to administer it before the onset of the RSV season to ensure optimal protection.
| Short Descr | RSV MONOC ANTB SEASN .5ML IM | Medium Descr | RSV MONOCLONAL ANTB SEASONAL DOSE 0.5ML IM USE | Long Descr | Respiratory syncytial virus, monoclonal antibody, seasonal dose; 0.5 mL dosage, for intramuscular use | Status Code | Non-Covered Service | Global Days | XXX - Global Concept Does Not Apply | PC/TC Indicator (26, TC) | 9 - Not Applicable | Multiple Procedures (51) | 9 - Concept does not apply. | Bilateral Surgery (50) | 9 - Concept does not apply. | Physician Supervisions | 09 - Concept does not apply. | Assistant Surgeon (80, 82) | 9 - Concept does not apply. | Co-Surgeons (62) | 9 - Concept does not apply. | Team Surgery (66) | 9 - Concept does not apply. | Diagnostic Imaging Family | 99 - Concept Does Not Apply | APC Status Indicator | Items and Services Not Billable to the MAC | Type of Service (TOS) | 1 - Medical Care | Berenson-Eggers TOS (BETOS) | none | MUE | 1 |
| 25 | Significant, separately identifiable evaluation and management service by the same physician or other qualified health care professional on the same day of the procedure or other service: it may be necessary to indicate that on the day a procedure or service identified by a cpt code was performed, the patient's condition required a significant, separately identifiable e/m service above and beyond the other service provided or beyond the usual preoperative and postoperative care associated with the procedure that was performed. a significant, separately identifiable e/m service is defined or substantiated by documentation that satisfies the relevant criteria for the respective e/m service to be reported (see evaluation and management services guidelines for instructions on determining level of e/m service). the e/m service may be prompted by the symptom or condition for which the procedure and/or service was provided. as such, different diagnoses are not required for reporting of the e/m services on the same date. this circumstance may be reported by adding modifier 25 to the appropriate level of e/m service. note: this modifier is not used to report an e/m service that resulted in a decision to perform surgery. see modifier 57 for significant, separately identifiable non-e/m services, see modifier 59. | GZ | Item or service expected to be denied as not reasonable and necessary | SL | State supplied vaccine |
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| 2024-01-01 | Added | First appearance in CodeBook |
| 2023-07-17 | Added | Code released on June 30, 2023 and effective 2023-07-17. FDA approval received. |
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