© Copyright 2025 American Medical Association. All rights reserved.
The CPT® Code 90657 refers to a specific formulation of the influenza virus vaccine, known as the trivalent inactivated influenza vaccine (IIV3). This vaccine is designed for intramuscular administration and is characterized by its split virus composition. Unlike immune globulins, which offer short-term, passive immunity, vaccines like this one provide active, long-term immunity. This is achieved by introducing altered versions of the influenza virus into the recipient's immune system, prompting the body to produce its own antibodies. These antibodies enable the immune system to recognize and combat the actual virus upon future exposure. The trivalent influenza vaccine is formulated to include three distinct strains of the influenza virus: two strains from influenza type A and one strain from influenza type B. The production process involves using embryonated chicken eggs, where the virus is cultivated, harvested, and then inactivated using formaldehyde. Following this, the virus is concentrated, purified, and chemically disrupted to create a split virus, which is further purified to ensure safety and efficacy. It is important to note that the CPT® Code 90657 specifically pertains to a 0.25 mL dosage of this vaccine, while a different code, 90658, is used for a 0.5 mL dosage. These codes are strictly for reporting the vaccine product itself, and any intramuscular injection associated with the administration of the vaccine should be reported separately.
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The trivalent influenza virus vaccine (IIV3) is indicated for the prevention of influenza caused by the specific strains included in the vaccine formulation. The vaccine is recommended for individuals who are at risk of contracting influenza, particularly during the influenza season. This includes populations such as young children, elderly individuals, pregnant women, and those with chronic health conditions that may increase the risk of severe influenza complications.
The administration of the trivalent influenza virus vaccine involves several key procedural steps to ensure safety and efficacy. First, the healthcare provider prepares the vaccine by ensuring that it is stored at the appropriate temperature and is not expired. The provider then selects the appropriate dosage, which in this case is 0.25 mL for CPT® Code 90657. Following this, the provider cleans the injection site on the patient's arm with an antiseptic wipe to minimize the risk of infection. The vaccine is then drawn into a sterile syringe, ensuring that no air bubbles are present. The provider will then hold the syringe like a dart and insert the needle into the muscle of the upper arm at a 90-degree angle. After the injection, the provider may apply gentle pressure to the site with a cotton ball or gauze and may cover it with a bandage if necessary. Finally, the provider documents the administration of the vaccine in the patient's medical record, including the date, site of administration, and any adverse reactions observed.
After the administration of the trivalent influenza virus vaccine, patients are typically monitored for a short period to observe for any immediate adverse reactions, such as allergic responses. Common post-procedure care includes advising the patient to rest and hydrate adequately. Patients may experience mild side effects, such as soreness at the injection site, low-grade fever, or fatigue, which usually resolve within a few days. It is important for healthcare providers to inform patients about these potential side effects and to encourage them to report any unusual or severe reactions. Additionally, patients should be advised to keep track of their vaccination status for future reference and to ensure they receive the vaccine annually, as influenza strains can change from year to year.
| Short Descr | IIV3 VACCINE SPLT 0.25 ML IM | Medium Descr | IIV3 VACCINE SPLIT VIRUS 0.25 ML DOSAGE IM USE | Long Descr | Influenza virus vaccine, trivalent (IIV3), split virus, 0.25 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 |
| 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. | 95 | Synchronous telemedicine service rendered via a real-time interactive audio and video telecommunications system: synchronous telemedicine service is defined as a real-time interaction between a physician or other qualified health care professional and a patient who is located at a distant site from the physician or other qualified health care professional. the totality of the communication of information exchanged between the physician or other qualified health care professional and the patient during the course of the synchronous telemedicine service must be of an amount and nature that would be sufficient to meet the key components and/or requirements of the same service when rendered via a face-to-face interaction. modifier 95 may only be appended to the services listed in appendix p. appendix p is the list of cpt codes for services that are typically performed face-to-face, but may be rendered via a real-time (synchronous) interactive audio and video telecommunications system. |
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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 |
| 2011-01-01 | Changed | Short description changed. |
| 2007-01-01 | Changed | Code description changed. |
| 2004-01-01 | Changed | Code description changed. |
| 1999-01-01 | Added | First appearance in code book in 1999. |
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