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A trivalent, split virus influenza vaccine (IIV3) is designed for intramuscular administration and is specifically formulated to provide active, long-term immunity against influenza. Unlike immune globulins, which offer short-term, passive immunity, this vaccine works by stimulating the recipient's immune system to recognize and combat the influenza virus. The vaccine contains altered versions of the virus, prompting the immune system to produce its own antibodies. This process enables the body to "remember" how to generate these antibodies upon future exposure to the actual virus, thereby enhancing the individual's ability to fight off influenza infections. The vaccine is produced using embryonated chicken eggs, where the influenza virus is cultivated, harvested, and inactivated with formaldehyde. The virus is then concentrated, purified, and chemically disrupted to create a split virus, which is further purified to ensure safety and efficacy. The trivalent formulation includes two distinct strains of influenza type A and one strain of influenza type B, providing broad protection against circulating influenza viruses. For billing purposes, the CPT® code 90658 is used to report the 0.5 mL dosage of this vaccine, while a separate code, 90657, is designated for a 0.25 mL dosage. It is important to note that these codes solely represent the vaccine product administered, and the intramuscular injection itself should be reported separately.
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The trivalent, split virus influenza vaccine (IIV3) is indicated for the prevention of influenza in individuals who are at risk of contracting the virus. The following conditions and circumstances warrant the administration of this vaccine:
The administration of the trivalent, split virus influenza vaccine involves several key procedural steps to ensure proper delivery and effectiveness:
Post-procedure care following the administration of the trivalent influenza vaccine includes monitoring the patient for any immediate side effects, which may include soreness at the injection site, low-grade fever, or mild fatigue. These reactions are generally mild and resolve on their own within a few days. Patients are advised to rest and stay hydrated. It is also important to inform patients about potential delayed reactions and when to seek medical attention. Additionally, individuals should be educated on the importance of receiving the vaccine annually, as influenza viruses can change from year to year, necessitating updated vaccinations for optimal protection.
| Short Descr | IIV3 VACCINE SPLT 0.5 ML IM | Medium Descr | IIV3 VACCINE SPLIT VIRUS 0.5 ML DOSAGE IM USE | Long Descr | Influenza virus vaccine, trivalent (IIV3), split virus, 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 |
| 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. | CC | Procedure code change (use 'cc' when the procedure code submitted was changed either for administrative reasons or because an incorrect code was filed) | SL | State supplied vaccine |
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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. |
| 2008-01-01 | Changed | Code 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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