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A trivalent, split virus, preservative-free influenza vaccine (IIV3) is designed for intramuscular administration. This vaccine differs from immune globulins, which provide short-term, passive immunity; instead, it offers active, long-term immunity. The mechanism of action involves exposing the recipient's immune system to altered versions of specific influenza viruses, prompting the immune system to produce its own antibodies. This process enables the body to "remember" how to generate antibodies upon subsequent exposure to the same antigens. The formulation is specifically preservative-free, meaning it does not contain the preservative thimerosal or contains only trace amounts, thus classified as either thimerosal-free or thimerosal-reduced. The U.S. Food and Drug Administration (FDA) recognizes both formulations as preservative-free. The vaccine is administered via intramuscular injection, which is a separate procedure that should be reported independently. The production of the influenza vaccine involves the use of embryonated chicken eggs, where the virus is harvested, inactivated with formaldehyde, concentrated, purified, and chemically disrupted to create a split virus. This trivalent vaccine is formulated to protect against three specific influenza viruses, including two distinct strains of influenza type A and one strain of influenza type B. For coding purposes, the CPT® code 90656 is designated for the 0.5 mL dosage of this vaccine, while code 90655 is used for a 0.25 mL dosage, with both codes solely reporting the vaccine product used.
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The trivalent, split virus, preservative-free influenza vaccine (IIV3) is indicated for the prevention of influenza caused by specific strains of the virus. The vaccine is recommended for individuals who are at risk of influenza complications, including but not limited to:
The administration of the trivalent, split virus, preservative-free influenza vaccine involves several key procedural steps:
Post-procedure care for the administration of the influenza vaccine includes monitoring the patient for any immediate adverse reactions, such as allergic responses or injection site reactions. Patients may experience mild side effects, including soreness at the injection site, low-grade fever, or fatigue, which typically resolve within a few days. It is important to provide patients with information regarding these potential side effects and to encourage them to seek medical attention if they experience severe or persistent symptoms. Additionally, patients should be advised to continue practicing preventive measures against influenza, such as hand hygiene and avoiding close contact with sick individuals, especially during flu season.
| Short Descr | IIV3 VACC NO PRSV 0.5 ML IM | Medium Descr | IIV3 VACC PRESERVATIVE FREE 0.5 ML DOSAGE IM USE | Long Descr | Influenza virus vaccine, trivalent (IIV3), split virus, preservative free, 0.5 mL dosage, for intramuscular use | Related Drugs | Afluria | Status Code | Statutory Exclusion (from MPFS, may be paid under other methodologies) | 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 | Influenza, Pneumococcal Pneumonia, Hepatitis B, and Covid-19 Vaccines; Monoclonal Antibody Therapy Product | ASC Payment Indicator | Influenza vaccine; pneumococcal vaccine. | Type of Service (TOS) | V - Pneumococcal/Flu Vaccine | Berenson-Eggers TOS (BETOS) | O1G - Immunizations/Vaccinations | MUE | 1 | CCS Clinical Classification | 228 - Prophylactic vaccinations and inoculations |
| 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. | 59 | Distinct procedural service: under certain circumstances, it may be necessary to indicate that a procedure or service was distinct or independent from other non-e/m services performed on the same day. modifier 59 is used to identify procedures/services, other than e/m services, that are not normally reported together, but are appropriate under the circumstances. documentation must support a different session, different procedure or surgery, different site or organ system, separate incision/excision, separate lesion, or separate injury (or area of injury in extensive injuries) not ordinarily encountered or performed on the same day by the same individual. however, when another already established modifier is appropriate it should be used rather than modifier 59. only if no more descriptive modifier is available, and the use of modifier 59 best explains the circumstances, should modifier 59 be used. note: modifier 59 should not be appended to an e/m service. to report a separate and distinct e/m service with a non-e/m service performed on the same date, see modifier 25. | GC | This service has been performed in part by a resident under the direction of a teaching physician | GV | Attending physician not employed or paid under arrangement by the patient's hospice provider | Q6 | Service furnished under a fee-for-time compensation arrangement by a substitute physician or by a substitute physical therapist furnishing outpatient physical therapy services in a health professional shortage area, a medically underserved area, or a rural area | SL | State supplied vaccine | U1 | Medicaid level of care 1, as defined by each state |
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Action
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Notes
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| 2017-01-01 | Changed | Long, Medium and Short descriptions changed. |
| 2016-01-01 | Changed | First appearance of change in codebook. |
| 2015-07-01 | Changed | Description Changed |
| 2013-01-01 | Changed | Description Changed |
| 2008-01-01 | Changed | Code description changed. |
| 2007-01-01 | Changed | Code description changed. |
| 2005-01-01 | Added | First appearance in code book in 2005. |
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