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The CPT® Code 90667 refers to the influenza virus vaccine specifically formulated for pandemic situations. This vaccine is a split virus type, which means it is created from a virus that has been inactivated and broken into smaller pieces, allowing the immune system to recognize and respond to it without causing disease. The pandemic formulation is distinct from standard influenza vaccines as it is designed to address new strains of the virus that emerge during pandemics, when the population has little to no pre-existing immunity. This vaccine is adjuvanted, meaning it contains additional substances that enhance the body's immune response to the vaccine, thereby increasing its effectiveness. The vaccine is administered via intramuscular injection, which is a common route for delivering vaccines, ensuring that the vaccine components are effectively absorbed into the bloodstream. The production of this vaccine involves several steps, including the use of embryonated chicken eggs for virus cultivation, inactivation with formaldehyde, concentration, purification, and chemical disruption to create the split virus. This process ensures that the vaccine is safe and effective for use, particularly in vulnerable populations such as the elderly, who may have a reduced immune response. The distinction between this adjuvanted formulation and other types of influenza vaccines, such as preservative-free options, is crucial for proper coding and billing in medical practices.
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The influenza virus vaccine (IIV), pandemic formulation, split virus, adjuvanted, is indicated for use in specific populations, particularly those at higher risk of severe illness due to influenza. The following conditions and circumstances warrant the administration of this vaccine:
The administration of the influenza virus vaccine (CPT® Code 90667) involves several key procedural steps to ensure safety and efficacy:
Following the administration of the influenza virus vaccine, patients may experience mild side effects, which are generally self-limiting. Common post-procedure care includes advising patients to rest and hydrate adequately. They should be informed about potential side effects such as soreness at the injection site, low-grade fever, or fatigue, which typically resolve within a few days. Patients should also be instructed to seek medical attention if they experience any severe or unusual reactions. It is important to document the administration of the vaccine in the patient's medical record, including the date, site of injection, and any observed reactions. Additionally, patients should be encouraged to receive the vaccine annually, as influenza strains can change from year to year, necessitating updated vaccinations for optimal protection.
| Short Descr | IIV VACC PANDEMIC ADJUVT IM | Medium Descr | IIV VACCINE PANDEMIC ADJUVANT FOR IM USE | Long Descr | Influenza virus vaccine (IIV), pandemic formulation, split virus, adjuvanted, for intramuscular use | 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 | Non-Covered Service, not paid under OPPS | 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. | XU | Unusual non-overlapping service, the use of a service that is distinct because it does not overlap usual components of the main service |
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Notes
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| 2016-01-01 | Changed | First appearance of change in codebook. |
| 2015-07-01 | Changed | Description Changed. FDA approval pending |
| 2011-01-01 | Added | First appearance in code book |
| 2010-07-01 | Added | Implemented |
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